Provider Demographics
NPI:1760903371
Name:CULLMAN, ASHLEE (BCABA)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:CULLMAN
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E 54TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-3219
Mailing Address - Country:US
Mailing Address - Phone:317-288-3396
Mailing Address - Fax:317-288-3396
Practice Address - Street 1:1025 E 54TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46220-3219
Practice Address - Country:US
Practice Address - Phone:317-584-5166
Practice Address - Fax:317-288-3396
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst