Healthcare Provider Details

I. General information

NPI: 1407667017
Provider Name (Legal Business Name): ASHLIE DUPUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SANDCREST BLVD
COLUMBUS IN
47203-3053
US

IV. Provider business mailing address

2600 SANDCREST BLVD
COLUMBUS IN
47203-3053
US

V. Phone/Fax

Practice location:
  • Phone: 812-413-9321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16647
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: