Provider Demographics
NPI:1467813600
Name:JOSEPH, ASHLEY (MS)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:BOLASKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3370 MADISON AVE
Mailing Address - Street 2:UNIT 10B
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606
Mailing Address - Country:US
Mailing Address - Phone:413-348-4575
Mailing Address - Fax:
Practice Address - Street 1:30 HOLMES AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702
Practice Address - Country:US
Practice Address - Phone:203-707-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health