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General NPI Number Information
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NPI Number | 1821383597
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Entity Type | Individual
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Provider Name | ALICIA MAY CAMUSO MS SPECIAL EDUCATION
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Gender | Female
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 11 WEST AVE
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City | LAWRENCE
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State | NY
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Zip | 11559-1012
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Country | US
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Telephone | 516-371-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 11 WEST AVE
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City | LAWRENCE
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State | NY
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Zip | 11559-1012
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Country | US
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Telephone |
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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 | 430976101
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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