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General NPI Number Information
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NPI Number | 1548913817
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Entity Type | Individual
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Provider Name | ASHLEY TAYLOR ROSS
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Gender | Female
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Dates
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Enumeration Date | 01/27/2022
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 533 W STATE ST. #103
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City | PLEASANT GROVE
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State | UT
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Zip | 84062
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Country | US
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Telephone | 801-506-6695
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Fax |
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Provider Business Mailing Address
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Address Line | 727 E 200 S
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City | LINDON
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State | UT
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Zip | 84042-2112
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Country | US
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Telephone | 801-615-1209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB712951
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License Number State | UT
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