Provider Demographics
NPI:1932597184
Name:BENEDETTO, ASHLEY MOTTOLA
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MOTTOLA
Last Name:BENEDETTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MARIE
Other - Last Name:MOTTOLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2600 WAYLAND RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2307
Mailing Address - Country:US
Mailing Address - Phone:610-325-4734
Mailing Address - Fax:
Practice Address - Street 1:2600 WAYLAND RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-2307
Practice Address - Country:US
Practice Address - Phone:610-325-4734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2014-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst