Provider Demographics
NPI:1417378357
Name:ASHTON KINDY, VANESSA (MA BCBA)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:ASHTON KINDY
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 HOLBROOK CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-6332
Mailing Address - Country:US
Mailing Address - Phone:407-342-4220
Mailing Address - Fax:
Practice Address - Street 1:250 S RONALD REAGAN BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5466
Practice Address - Country:US
Practice Address - Phone:407-342-4220
Practice Address - Fax:888-808-5278
Is Sole Proprietor?:No
Enumeration Date:2013-12-19
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist