Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY9817 | FL |
NPI | 1083848147 |
---|---|
Provider Name | Alicia Teresa Rozycki |
First Address | Peterson Afb, CO 80914-1540 |
Second Address | Peterson Afb, CO 80914-1540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2009 |
Last Update Date | 26/12/2019 |