Provider Demographics
NPI:1073942728
Name:DELGADO-AGUDIO, ALICIA (MFT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:DELGADO-AGUDIO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 LEYDEN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1824
Mailing Address - Country:US
Mailing Address - Phone:631-639-8227
Mailing Address - Fax:
Practice Address - Street 1:21 LEYDEN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1824
Practice Address - Country:US
Practice Address - Phone:631-639-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist