Provider Demographics
NPI:1770151433
Name:VLIET, ASHLEY (RBT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:VLIET
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 1:1601 S MOPAC EXPY STE C300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-7077
Mailing Address - Country:US
Mailing Address - Phone:512-920-1030
Mailing Address - Fax:512-256-1983
Practice Address - Street 1:37200 N GANTZEL RD STE 150
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-7383
Practice Address - Country:US
Practice Address - Phone:520-484-1111
Practice Address - Fax:602-926-0352
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1-23-65163103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst