Provider Demographics
NPI:1467001313
Name:BATASTINI, ASHLEY BRIANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BRIANNE
Last Name:BATASTINI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 S 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7315
Mailing Address - Country:US
Mailing Address - Phone:610-413-8930
Mailing Address - Fax:
Practice Address - Street 1:412 S 22ND AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7315
Practice Address - Country:US
Practice Address - Phone:610-413-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS571006103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling