MEDICARE: ASHLEY CODIO BCABA

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
1	222Q00000X	Developmental Therapist
2	106S00000X	Behavior Technician	RBT-17-41443	FL
3	106E00000X	Assistant Behavior Analyst	0-25-16484	FL

General Provider Information

NPI Number	:	1184084907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY CODIO BCABA

Provider Business Mailing Address
First Line	:	5868 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:	952-767-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	5868 BAKER RD
Second Line	:
City	:	MINNETONKA
State	:	MN
Zip	:	55345-5903
Country	:	US
Telephone Number	:	952-767-4200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	12/22/2025

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Directions to “ ASHLEY CODIO BCABA” Practice Location

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