Provider Demographics
NPI:1033818828
Name:BOULIO-ALBERRY, KALEIGH
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:BOULIO-ALBERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 ARSENAL ST FL 5
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-2528
Mailing Address - Country:US
Mailing Address - Phone:315-785-3283
Mailing Address - Fax:
Practice Address - Street 1:175 ARSENAL ST FL 5
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-2528
Practice Address - Country:US
Practice Address - Phone:315-785-3283
Practice Address - Fax:315-785-5182
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator