Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-07-3453 | WA |
NPI | 1003069634 |
---|---|
Provider Name | Stacey Ashton |
First Address | Pacific Grove, CA 93950-2714 |
Second Address | Pacific Grove, CA 93950-2714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 05/07/2012 |