MEDICARE: MS. ASHLIE GRILL WALKER BCBA

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	1106749	AL

General Provider Information

NPI Number	:	1649502618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLIE GRILL WALKER BCBA

Provider Business Mailing Address
First Line	:	2215 SUMMER RIDGE DR
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35226-1585
Country	:	US
Telephone Number	:	205-253-6903
Fax Number	:	205-278-5869

Provider Business Practice Location Address
First Line	:	4244 CAHABA HEIGHTS CT
Second Line	:
City	:	VESTAVIA
State	:	AL
Zip	:	35243-5711
Country	:	US
Telephone Number	:	205-253-6903
Fax Number	:	205-278-5869

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

Provider Enumeration Date	:	02/02/2010
Last Update Date	:	03/26/2015

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