Provider Demographics
NPI:1578807467
Name:ALTERSON, CINDY JOYCE (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:JOYCE
Last Name:ALTERSON
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SCHUMAN RD
Mailing Address - Street 2:DEVEREUX MILLWOOD LEARNING CENTER
Mailing Address - City:MILLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:10546-1111
Mailing Address - Country:US
Mailing Address - Phone:914-941-1991
Mailing Address - Fax:914-941-2852
Practice Address - Street 1:14 SCHUMAN RD
Practice Address - Street 2:DEVEREUX MILLWOOD LEARNING CENTER
Practice Address - City:MILLWOOD
Practice Address - State:NY
Practice Address - Zip Code:10546-1111
Practice Address - Country:US
Practice Address - Phone:914-941-1991
Practice Address - Fax:914-941-2852
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-16
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-00-0002103K00000X
NY014560103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst