Provider Demographics
NPI:1629969472
Name:VANDIVER, ASHLEY (RBT-25-422942)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:VANDIVER
Suffix:
Gender:F
Credentials:RBT-25-422942
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ENOCHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5705 HORIZON ROAD
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032
Mailing Address - Country:US
Mailing Address - Phone:469-264-5246
Mailing Address - Fax:
Practice Address - Street 1:5705 HORIZON ROAD
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:469-264-5246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-25-422942106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician