Provider Demographics
NPI:1972215267
Name:PALATNIK, ASHANTI MARIE
Entity type:Individual
Prefix:
First Name:ASHANTI
Middle Name:MARIE
Last Name:PALATNIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4115 SALFORD CT
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-4835
Mailing Address - Country:US
Mailing Address - Phone:914-343-0511
Mailing Address - Fax:
Practice Address - Street 1:4115 SALFORD CT
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4835
Practice Address - Country:US
Practice Address - Phone:914-343-0511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist