Provider Demographics
NPI:1457010233
Name:ROBINSON, ASHTYN BROOKE
Entity Type:Individual
Prefix:
First Name:ASHTYN
Middle Name:BROOKE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHTYN
Other - Middle Name:BROOKE
Other - Last Name:DOWDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:315 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-6743
Mailing Address - Country:US
Mailing Address - Phone:812-413-9321
Mailing Address - Fax:812-413-9323
Practice Address - Street 1:315 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6743
Practice Address - Country:US
Practice Address - Phone:812-413-9321
Practice Address - Fax:812-413-9323
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-21-194156106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician