Provider Demographics
NPI:1912546656
Name:BENZA, ASHLEY WOLLSCHEID (RBAI, RBT)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:WOLLSCHEID
Last Name:BENZA
Suffix:
Gender:F
Credentials:RBAI, RBT
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:WOLLSCHEID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11481 SW HALL BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8403
Mailing Address - Country:US
Mailing Address - Phone:597-125-8555
Mailing Address - Fax:
Practice Address - Street 1:11481 SW HALL BLVD STE 104
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97223-8403
Practice Address - Country:US
Practice Address - Phone:971-258-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-28
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician