Provider Demographics
NPI:1528893385
Name:BENDER, ANSLEY MARIE (PHD)
Entity type:Individual
Prefix:DR
First Name:ANSLEY
Middle Name:MARIE
Last Name:BENDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 E 12TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-3888
Mailing Address - Country:US
Mailing Address - Phone:913-717-0172
Mailing Address - Fax:
Practice Address - Street 1:521 E 12TH ST APT 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-3888
Practice Address - Country:US
Practice Address - Phone:913-717-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026650103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical