Provider Demographics
NPI:1366850182
Name:WANSICK, ASHLEE MARIE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MARIE
Last Name:WANSICK
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 1:94 STIMSON ST
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-9638
Mailing Address - Country:US
Mailing Address - Phone:413-244-0011
Mailing Address - Fax:
Practice Address - Street 1:94 STIMSON ST
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-9638
Practice Address - Country:US
Practice Address - Phone:413-244-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor