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NPI Code Detail

MEDICARE: MRS. ASHLEY MCCORY

MEDICARE: MRS. ASHLEY MCCORY
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 Analyst
2106S00000XBehavior Technician

General Provider Information

NPI Number : 1720482250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY MCCORY
Provider Business Mailing Address
First Line : 3435 W 96TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1102
Country : US
Telephone Number : 317-802-7447
Fax Number : 317-802-7325
Provider Business Practice Location Address
First Line : 3435 W 96TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-1102
Country : US
Telephone Number : 317-802-7447
Fax Number : 317-802-7325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2014
Last Update Date : 01/21/2021

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Directions to “ MRS. ASHLEY MCCORY ” Practice Location

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