Provider Demographics
NPI:1225647076
Name:MINTER, ASHLEY NICOLE (BA)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:NICOLE
Last Name:MINTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SOUTHARD ST BLDG 4
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08609-1020
Mailing Address - Country:US
Mailing Address - Phone:609-647-1131
Mailing Address - Fax:
Practice Address - Street 1:10 SOUTHARD ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08609-1020
Practice Address - Country:US
Practice Address - Phone:609-396-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health