Provider Demographics
NPI:1881276202
Name:WATTS, ASIOHBAN SHAVAY (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ASIOHBAN
Middle Name:SHAVAY
Last Name:WATTS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:ASIOHBAN
Other - Middle Name:SHAVAY
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:805 ALEXA DR STE D
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1000
Mailing Address - Country:US
Mailing Address - Phone:859-444-5664
Mailing Address - Fax:
Practice Address - Street 1:805 ALEXA DR STE D
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1000
Practice Address - Country:US
Practice Address - Phone:859-444-5664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-24-71697103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst