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General NPI Number Information
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NPI Number | 1679399653
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Entity Type | Individual
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Provider Name | EMMA ASHLEY
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Gender | Female
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Dates
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Enumeration Date | 11/25/2024
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 3101 N. CANTERBURY COURT
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City | BLOOMINGTON
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State | IN
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Zip | 47404-4500
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Country | US
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Telephone | 317-249-2242
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Fax |
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Provider Business Mailing Address
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Address Line | 4665 PARIS ST
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City | DENVER
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State | CO
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Zip | 80239-3126
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Country | US
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Telephone |
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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 | RBT-22-237831
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-79093
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License Number State | IN
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