Provider Demographics
NPI:1427409044
Name:GILLESPIE, ASHLEY REISS (MS BCBA, LABA)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:REISS
Last Name:GILLESPIE
Suffix:
Gender:F
Credentials:MS BCBA, LABA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:REISS
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA, LABA
Mailing Address - Street 1:1390 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2269
Mailing Address - Country:US
Mailing Address - Phone:978-216-0300
Mailing Address - Fax:978-851-1030
Practice Address - Street 1:1390 MAIN ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-2269
Practice Address - Country:US
Practice Address - Phone:978-216-0300
Practice Address - Fax:978-851-1030
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
MA1-13-14132103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst