Provider Demographics
NPI:1407265440
Name:MCLEAN-ROWE, ALICIA SASHA (MSED)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:SASHA
Last Name:MCLEAN-ROWE
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10438 203RD ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-1320
Mailing Address - Country:US
Mailing Address - Phone:347-242-1725
Mailing Address - Fax:
Practice Address - Street 1:10438 203RD ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-1320
Practice Address - Country:US
Practice Address - Phone:347-242-1725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY868245141252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency