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Individual

MS. ASHLEY LYNNE-THERESA CANTRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, BCBA, LBA

Contact information

Practice address
666 E MAIN ST STE B, CENTREVILLE, MI 49032-9803
(269) 241-2700
Mailing address
666 E MAIN ST STE B, CENTREVILLE, MI 49032-9803
(269) 241-2700

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48318
MI
156F00000X
Technician/Technologist
BACB88877
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447874573
MI
Enumeration date
06/04/2020
Last updated
09/23/2022
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