Provider Demographics
NPI:1134904980
Name:CROSS, ASHLEY M (BCBA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:CROSS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15047 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-6475
Mailing Address - Country:US
Mailing Address - Phone:208-771-8840
Mailing Address - Fax:
Practice Address - Street 1:8680 N WAYNE DR
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-5037
Practice Address - Country:US
Practice Address - Phone:208-635-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst