Provider Demographics
NPI:1730545302
Name:CALLENDER, ASHLEY
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:CALLENDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 NOSTRAND AVE
Mailing Address - Street 2:3E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5262
Mailing Address - Country:US
Mailing Address - Phone:718-791-8413
Mailing Address - Fax:
Practice Address - Street 1:3571 NOSTRAND AVE
Practice Address - Street 2:3E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5262
Practice Address - Country:US
Practice Address - Phone:718-791-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123016548103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst