Provider Demographics
NPI:1851040935
Name:BURNETT, ALETHEA
Entity Type:Individual
Prefix:
First Name:ALETHEA
Middle Name:
Last Name:BURNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALETHEA
Other - Middle Name:
Other - Last Name:BETANCES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:29 ERNST RD
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-1158
Mailing Address - Country:US
Mailing Address - Phone:347-346-3718
Mailing Address - Fax:
Practice Address - Street 1:3033 GODWIN TER APT 4C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5344
Practice Address - Country:US
Practice Address - Phone:646-204-2295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health