Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 017152-1 | NY |
NPI | 1245537414 |
---|---|
Provider Name | Dr. Alicia Helena Mcauliffe-Fogatry |
First Address | Montrose, NY 10548-1115 |
Second Address | Montrose, NY 10548-1115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2011 |
Last Update Date | 23/02/2011 |