Provider Demographics
NPI:1093251415
Name:HAURAND, ASHLEY (RBT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HAURAND
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1376
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:VA
Mailing Address - Zip Code:23181-1376
Mailing Address - Country:US
Mailing Address - Phone:804-366-5869
Mailing Address - Fax:
Practice Address - Street 1:34 WOODFIN RD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-4217
Practice Address - Country:US
Practice Address - Phone:804-366-5869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-09
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VARBT-18-51801106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
VARBT-18-51801OtherBACB