Healthcare Provider Details

I. General information

NPI: 1952489932
Provider Name (Legal Business Name): ALICIA S HLYWAK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 THOMAS JONES WAY SUITE #800
EXTON PA
19341
US

IV. Provider business mailing address

479 THOMAS JONES WAY SUITE #800
EXTON PA
19341
US

V. Phone/Fax

Practice location:
  • Phone: 610-648-1130
  • Fax: 610-560-8219
Mailing address:
  • Phone: 610-648-1130
  • Fax: 610-560-8219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: