Provider Demographics
NPI:1467261925
Name:ASCHENBRENNER, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:ASCHENBRENNER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 CAROLINE ST APT 3D
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5837
Mailing Address - Country:US
Mailing Address - Phone:540-762-9096
Mailing Address - Fax:
Practice Address - Street 1:10510 SPOTSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-2693
Practice Address - Country:US
Practice Address - Phone:540-479-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000592106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst