Provider Demographics
NPI:1972178622
Name:HANSON, ASHLAND MORGAN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:ASHLAND
Middle Name:MORGAN
Last Name:HANSON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:N WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04061-4655
Mailing Address - Country:US
Mailing Address - Phone:207-239-4577
Mailing Address - Fax:
Practice Address - Street 1:37 ANDOVER RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1936
Practice Address - Country:US
Practice Address - Phone:207-661-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1-20-41720103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst