Provider Demographics
NPI:1881091494
Name:FLYNN-PRIVETT, ASHLEY (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:FLYNN-PRIVETT
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 1ST ST E APT 117
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-3038
Mailing Address - Country:US
Mailing Address - Phone:843-602-2386
Mailing Address - Fax:
Practice Address - Street 1:647 13TH AVE E
Practice Address - Street 2:A
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-3328
Practice Address - Country:US
Practice Address - Phone:701-277-8844
Practice Address - Fax:701-277-8847
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND14103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst