Healthcare Provider Details

I. General information

NPI: 1467133363
Provider Name (Legal Business Name): ASHLEY BEHAVIOR CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2023
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4261 HOME STRETCH DR
PARKTON NC
28371-8799
US

IV. Provider business mailing address

4261 HOME STRETCH DR
PARKTON NC
28371-8799
US

V. Phone/Fax

Practice location:
  • Phone: 424-207-4521
  • Fax:
Mailing address:
  • Phone: 424-207-4521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIANNA A ASHLEY ORTIZ
Title or Position: OWNER
Credential: BCBA
Phone: 424-207-4521