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NPI Code Detail

MEDICARE: ASHLEY M CROOMS

MEDICARE: ASHLEY M CROOMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1033973920
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY M CROOMS
Provider Business Mailing Address
First Line : 3190 NORTHEAST EXPY NE STE 110
Second Line :
City : ATLANTA
State : GA
Zip : 30341-5323
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3190 NORTHEAST EXPY NE STE 110
Second Line :
City : ATLANTA
State : GA
Zip : 30341-5323
Country : US
Telephone Number : 404-487-6005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2024
Last Update Date : 02/12/2024

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Directions to “ ASHLEY M CROOMS ” Practice Location

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