Provider Demographics
NPI:1396090494
Name:GALIC, SOFIJA SONJA (MA BCBA CBA)
Entity type:Individual
Prefix:MS
First Name:SOFIJA
Middle Name:SONJA
Last Name:GALIC
Suffix:
Gender:F
Credentials:MA BCBA CBA
Other - Prefix:
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Mailing Address - Street 1:151 1ST AVE APT
Mailing Address - Street 2:APT 117
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:917-583-3730
Mailing Address - Fax:518-777-3293
Practice Address - Street 1:120 BENCHELY PLACE
Practice Address - Street 2:FRONT 2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3402
Practice Address - Country:US
Practice Address - Phone:347-843-7760
Practice Address - Fax:347-843-7780
Is Sole Proprietor?:No
Enumeration Date:2012-07-16
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
174400000X
NY002067-01103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist