Healthcare Provider Details

I. General information

NPI: 1629716097
Provider Name (Legal Business Name): CAROLYN GRACE BRIER ASHMAN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 VIRGINIA AVE
WILMINGTON NC
28401-7000
US

IV. Provider business mailing address

2705 LONGLEAF PINE CIR
LELAND NC
28451-4400
US

V. Phone/Fax

Practice location:
  • Phone: 919-375-0475
  • Fax:
Mailing address:
  • Phone: 910-442-8907
  • 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:
Title or Position:
Credential:
Phone: