Provider Demographics
NPI:1568744563
Name:MCINTYRE, ASHLEY LAUREN (RN,BSN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAUREN
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22677 N MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-9373
Mailing Address - Country:US
Mailing Address - Phone:405-301-6540
Mailing Address - Fax:
Practice Address - Street 1:425 FRETZ AVE
Practice Address - Street 2:E & F
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5532
Practice Address - Country:US
Practice Address - Phone:405-506-6703
Practice Address - Fax:405-562-1868
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst