Provider Demographics
NPI:1245937572
Name:BURNS, ASHLEY (RBT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BURNS
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 1:777 E 15TH ST APT 326
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5018
Mailing Address - Country:US
Mailing Address - Phone:806-543-6587
Mailing Address - Fax:
Practice Address - Street 1:1712 S POST RD STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6614
Practice Address - Country:US
Practice Address - Phone:405-394-4831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRBT-23-256248106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician