Provider Demographics
NPI:1255839627
Name:EBRON, ASHLEY (BS, MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:EBRON
Suffix:
Gender:F
Credentials:BS, MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3853 SWEETBRIAR CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-2128
Mailing Address - Country:US
Mailing Address - Phone:757-513-4168
Mailing Address - Fax:
Practice Address - Street 1:4575 BONNEY RD STE 101
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3831
Practice Address - Country:US
Practice Address - Phone:757-428-3367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-31
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VA0133002778103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician