Provider Demographics
NPI:1225733975
Name:SIOLAS, AMALIA (PSYD)
Entity Type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:SIOLAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:AMALIA
Other - Middle Name:
Other - Last Name:ATHANASOPOULOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:15454 12TH RD
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-1945
Mailing Address - Country:US
Mailing Address - Phone:917-642-2526
Mailing Address - Fax:
Practice Address - Street 1:9110 146TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4301
Practice Address - Country:US
Practice Address - Phone:718-468-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool