Individual
ALIX WILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
489 E 153RD ST, BRONX, NY 10455-1307
(718) 742-7042
(718) 401-1321
Mailing address
489 E 153RD ST, BRONX, NY 10455-1307
(718) 742-7042
(718) 401-1321
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
079103-1
NY
Other
Enumeration date
11/10/2009
Last updated
11/10/2009
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