Healthcare Provider Details

I. General information

NPI: 1912522764
Provider Name (Legal Business Name): ASHLEY SORIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 BALTIMORE RD
ROCKVILLE MD
20850-1512
US

IV. Provider business mailing address

517 BALTIMORE RD
ROCKVILLE MD
20850-1512
US

V. Phone/Fax

Practice location:
  • Phone: 202-657-9800
  • Fax:
Mailing address:
  • Phone: 202-657-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA1360
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: