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General NPI Number Information
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NPI Number | 1053825455
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Entity Type | Individual
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Provider Name | ALICIA MARA MORGAN
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 380 US 202
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City | SOMERS
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State | NY
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Zip | 10589
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Country | US
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Telephone | 914-248-5060
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Fax |
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Provider Business Mailing Address
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Address Line | 437 BULLET HOLE RD
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City | PATTERSON
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State | NY
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Zip | 12563-2961
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Country | US
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Telephone | 845-661-5369
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002624-1
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License Number State | NY
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