Provider Demographics
NPI:1790161214
Name:MUSIAL, ASHLEY D (BCBA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:MUSIAL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 N MART CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2360
Mailing Address - Country:US
Mailing Address - Phone:847-322-8452
Mailing Address - Fax:
Practice Address - Street 1:705 N MART CT
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2360
Practice Address - Country:US
Practice Address - Phone:847-322-8452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-06
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst