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Individual
MRS. JESSICA VILLA ALICEA
Active
Individual
MRS. JESSICA VILLA ALICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
101703-1
NY
1041C0700X
Clinical Social Worker
Primary
095260
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285628552
1285628552
NY
Enumeration date
09/20/2016
Last updated
07/19/2023
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