Provider Demographics
NPI:1083848147
Name:ROZYCKI, ALICIA TERESA (PHD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:TERESA
Last Name:ROZYCKI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST
Mailing Address - Street 2:ATTN: 21 MDS - SGOF
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-567-4489
Mailing Address - Fax:877-813-1756
Practice Address - Street 1:559 VINCENT ST
Practice Address - Street 2:ATTN: 21 MDS - SGOF
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-567-4489
Practice Address - Fax:877-813-1756
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9817103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling