MEDICARE: ASHLEY WALTON 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
1	106S00000X	Behavior Technician	RBT-15-05617	GA

General Provider Information

NPI Number	:	1518469626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY WALTON RBT

Provider Business Mailing Address
First Line	:	1133 13TH ST
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2248
Country	:	US
Telephone Number	:	706-225-0101
Fax Number	:

Provider Business Practice Location Address
First Line	:	1133 13TH ST
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2248
Country	:	US
Telephone Number	:	706-225-0101
Fax Number	:	706-225-0052

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

Provider Enumeration Date	:	03/05/2018
Last Update Date	:	03/05/2018

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Directions to “ ASHLEY WALTON RBT” Practice Location

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