Provider Demographics
NPI:1770023632
Name:DASCOLA, ASHLEY (IWLC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DASCOLA
Suffix:
Gender:F
Credentials:IWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 TANGLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06461-1640
Mailing Address - Country:US
Mailing Address - Phone:203-253-7358
Mailing Address - Fax:
Practice Address - Street 1:37 GLENBROOK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2913
Practice Address - Country:US
Practice Address - Phone:203-998-6223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-26
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health