=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801753249
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANSLEY ELIZABETH DAUGHTRY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12313 US HIGHWAY 301 S
-----------------------------------------------------
City | STATESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30458-3218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-844-1232
-----------------------------------------------------
Fax | 800-844-1232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12313 US HIGHWAY 301 S
-----------------------------------------------------
City | STATESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30458-3218
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-844-1232
-----------------------------------------------------
Fax | 800-844-1232
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------