Healthcare Provider Details

I. General information

NPI: 1457286536
Provider Name (Legal Business Name): ALICIA WHITE PLATT AAHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 WAVERLEY DR APT T102
FREDERICK MD
21702-4835
US

IV. Provider business mailing address

90 WAVERLEY DR APT T102
FREDERICK MD
21702-4835
US

V. Phone/Fax

Practice location:
  • Phone: 617-420-7015
  • Fax: 617-340-3371
Mailing address:
  • Phone: 301-401-0893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: