Provider Demographics
NPI:1194378422
Name:MALEWICKI, ALICIA (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:MALEWICKI
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 BUGGY LN
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE
Mailing Address - State:VA
Mailing Address - Zip Code:22738-4083
Mailing Address - Country:US
Mailing Address - Phone:717-253-4388
Mailing Address - Fax:
Practice Address - Street 1:751 BUGGY LN
Practice Address - Street 2:
Practice Address - City:ROCHELLE
Practice Address - State:VA
Practice Address - Zip Code:22738-4083
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst