Healthcare Provider Details

I. General information

NPI: 1295228575
Provider Name (Legal Business Name): ASHLEY HARRIS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY BELL

II. Dates (important events)

Enumeration Date: 06/11/2018
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13322 I ST
OMAHA NE
68137-1111
US

IV. Provider business mailing address

13322 I ST
OMAHA NE
68137-1111
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-8863
  • Fax:
Mailing address:
  • Phone: 402-230-5861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-57912
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: