Individual
ALICIA BACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 EDUCATION DRIVE, SCHENECTADY, NY 12303
(518) 881-2000
Mailing address
54 KALLEN AVENUE, SCHENECTADY, NY 12304
(518) 810-1169
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
73077487
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01406986
—
NY
Enumeration date
09/27/2011
Last updated
09/27/2011
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