Provider Demographics
NPI:1326458274
Name:MADDALENI, ASHLEY LYNE
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:LYNE
Last Name:MADDALENI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PUMPKIN LN
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-4830
Mailing Address - Country:US
Mailing Address - Phone:978-821-1800
Mailing Address - Fax:
Practice Address - Street 1:20 PUMPKIN LN
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-4830
Practice Address - Country:US
Practice Address - Phone:978-821-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health