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NPI Code Detail

MEDICARE: ASHLYNN IRELAND

MEDICARE:   ASHLYNN  IRELAND
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
1106S00000XBehavior TechnicianRBT-24-373513IA

General Provider Information

NPI Number : 1780548453
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLYNN IRELAND
Provider Business Mailing Address
First Line : 1827 E IRELAND RD
Second Line :
City : SOUTH BEND
State : IN
Zip : 46614-2845
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5354 ELMORE AVE
Second Line :
City : DAVENPORT
State : IA
Zip : 52807-3859
Country : US
Telephone Number : 574-387-4313
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 12/16/2025

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Directions to “ ASHLYNN IRELAND ” Practice Location

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