Provider Demographics
NPI:1740673474
Name:AVERY, ASHLI (BCBA)
Entity type:Individual
Prefix:
First Name:ASHLI
Middle Name:
Last Name:AVERY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ASHLI
Other - Middle Name:
Other - Last Name:BURBRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:810 N LINDALE LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5107
Mailing Address - Country:US
Mailing Address - Phone:146-323-0502
Mailing Address - Fax:214-594-8232
Practice Address - Street 1:810 N LINDALE LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5107
Practice Address - Country:US
Practice Address - Phone:214-632-3050
Practice Address - Fax:214-594-8232
Is Sole Proprietor?:No
Enumeration Date:2015-03-04
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-9898103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst