Provider Demographics
NPI:1023753654
Name:BENSON, ASHLEE MICHELE (RD/ LD/N)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:MICHELE
Last Name:BENSON
Suffix:
Gender:F
Credentials:RD/ LD/N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 E PARK AVE STE I100
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2600
Mailing Address - Country:US
Mailing Address - Phone:850-270-6932
Mailing Address - Fax:850-270-6932
Practice Address - Street 1:820 E PARK AVE STE I100
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-2600
Practice Address - Country:US
Practice Address - Phone:850-765-6769
Practice Address - Fax:850-270-6932
Is Sole Proprietor?:No
Enumeration Date:2022-04-28
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND7938133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered