Provider Demographics
NPI:1629310180
Name:PAINTER, ASHLEY NICOLE-ESTES (BCBA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE-ESTES
Last Name:PAINTER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:NICOLE
Other - Last Name:ESTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:709 SADDLE TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-4322
Mailing Address - Country:US
Mailing Address - Phone:803-968-6927
Mailing Address - Fax:
Practice Address - Street 1:709 SADDLE TRAIL CT
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-4322
Practice Address - Country:US
Practice Address - Phone:803-968-6927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN514103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ096468Medicaid
TNQ051940Medicaid