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NPI Code Detail

MEDICARE: ASHLEY HOLLEY RBT

MEDICARE:   ASHLEY  HOLLEY  RBT
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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508266255
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY HOLLEY RBT
Provider Business Mailing Address
First Line : 4917 ELI ST
Second Line :
City : ORLANDO
State : FL
Zip : 32804-1717
Country : US
Telephone Number : 407-808-7837
Fax Number : 407-494-6057
Provider Business Practice Location Address
First Line : 4917 ELI ST
Second Line :
City : ORLANDO
State : FL
Zip : 32804-1717
Country : US
Telephone Number : 407-808-7837
Fax Number : 407-494-6057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2014
Last Update Date : 05/17/2019

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Directions to “ ASHLEY HOLLEY RBT” Practice Location

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