Individual
DR. ALYSA MACMILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
3045 E HENRIETTA RD, HENRIETTA, NY 14467-9300
(585) 506-6520
Mailing address
3045 E HENRIETTA RD, HENRIETTA, NY 14467-9300
(585) 506-6520
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
024738
NY
103TC0700X
Clinical Psychologist
Primary
024738
NY
Other
Enumeration date
08/14/2022
Last updated
08/14/2022
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