Provider Demographics
NPI:1407230196
Name:BERNIER, ALICIA MARIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MARIE
Last Name:BERNIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:ALICIA
Other - Middle Name:MARIE
Other - Last Name:CASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:410 CANAL PLACE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13365
Mailing Address - Country:US
Mailing Address - Phone:315-985-8556
Mailing Address - Fax:
Practice Address - Street 1:410 CANAL PLACE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NY
Practice Address - Zip Code:13365
Practice Address - Country:US
Practice Address - Phone:315-985-8556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist