Healthcare Provider Details

I. General information

NPI: 1407258593
Provider Name (Legal Business Name): ELIZABETH ANN ASHBY BSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 09/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 S 44TH ST
OMAHA NE
68131-3727
US

IV. Provider business mailing address

985450 NEBRASKA MEDICAL CTR
OMAHA NE
68198-5450
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-8863
  • Fax: 402-559-5737
Mailing address:
  • Phone: 402-559-8863
  • Fax: 402-559-5737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: