MEDICARE: ASHLEY BALDWIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-23-69563	TN

General Provider Information

NPI Number	:	1568184760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY BALDWIN

Provider Business Mailing Address
First Line	:	787 DUNK BLANTON RD
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-5925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	787 DUNK BLANTON RD
Second Line	:
City	:	TULLAHOMA
State	:	TN
Zip	:	37388-5925
Country	:	US
Telephone Number	:	317-409-4564
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2022
Last Update Date	:	03/31/2026

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Directions to “ ASHLEY BALDWIN ” Practice Location

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