Provider Demographics
NPI:1619103710
Name:DIPASQUALE, ALICIA MARIE (BSW)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:DIPASQUALE
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:MARIE
Other - Last Name:DOUD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:53 PARKER RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-9526
Mailing Address - Country:US
Mailing Address - Phone:585-975-9823
Mailing Address - Fax:
Practice Address - Street 1:39 DUNCAN ST
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:NY
Practice Address - Zip Code:14569-1017
Practice Address - Country:US
Practice Address - Phone:585-786-0190
Practice Address - Fax:585-786-0196
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor