Provider Demographics
NPI:1477002699
Name:BENOIT, ASHLEY N (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:BENOIT
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-1034
Mailing Address - Country:US
Mailing Address - Phone:812-287-8561
Mailing Address - Fax:812-954-0256
Practice Address - Street 1:10 N FULTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1034
Practice Address - Country:US
Practice Address - Phone:812-287-8561
Practice Address - Fax:812-954-0256
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-16-23213103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst