Ansley Ridgeway
Individual provider Active NPI Behavior Analyst · Gridley, IL
NPI 1023738705 · NPPES record last updated Sep 1, 2022
Key facts
- NPI
- 1023738705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 1-22-60867 (IL)
- Practice address
- 310 W 5TH St
Gridley, IL 61744-9793 - Phone
- (309) 532-3802
- NPI assigned
- Sep 1, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1-22-60867 | IL | Yes |
Addresses
Primary practice location
310 W 5TH St
Gridley, IL 61744-9793
Mailing address
310 W 5TH St
Gridley, IL 61744-9793
Phone (309) 532-3802
Other providers in Gridley, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.