Provider Demographics
NPI:1427299544
Name:ASHMEADE, KEVIN T
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:T
Last Name:ASHMEADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 683
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-0683
Mailing Address - Country:US
Mailing Address - Phone:615-673-4204
Mailing Address - Fax:615-866-5487
Practice Address - Street 1:104 HARTLEY CT
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-4034
Practice Address - Country:US
Practice Address - Phone:615-673-4204
Practice Address - Fax:615-866-5487
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst