Provider Demographics
NPI:1306242169
Name:HIGDON, ASHLEY ELIZABETH (MA, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:HIGDON
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:MOULDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 MCQUADE DR
Mailing Address - Street 2:
Mailing Address - City:ST. PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7804
Mailing Address - Country:US
Mailing Address - Phone:314-369-4235
Mailing Address - Fax:314-338-4159
Practice Address - Street 1:1601 MCQUADE DR
Practice Address - Street 2:
Practice Address - City:ST. PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-7804
Practice Address - Country:US
Practice Address - Phone:314-369-4235
Practice Address - Fax:314-338-4159
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014012487103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst