Provider Demographics
NPI:1619582566
Name:KREINER, ASHLEY SARAH
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SARAH
Last Name:KREINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 HIGHVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-6404
Mailing Address - Country:US
Mailing Address - Phone:516-241-0712
Mailing Address - Fax:
Practice Address - Street 1:305 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596-2102
Practice Address - Country:US
Practice Address - Phone:516-741-0729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-20-40894103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst