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NPI Code Detail

MEDICARE: ASHLEY KOOIMA BCBA

MEDICARE: ASHLEY KOOIMA BCBA
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
1103K00000XBehavior AnalystBCBA1-26-87972MO

General Provider Information

NPI Number : 1598436289
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY KOOIMA BCBA
Provider Business Mailing Address
First Line : 9144 DARLENE DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63123-4522
Country : US
Telephone Number : 314-348-4276
Fax Number :
Provider Business Practice Location Address
First Line : 3859 FEE FEE RD
Second Line :
City : BRIDGETON
State : MO
Zip : 63044-2937
Country : US
Telephone Number : 314-410-9670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2021
Last Update Date : 04/02/2026

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