Individual
ALESYA NAZAROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
171 E STATE ST APT 227, ITHACA, NY 14850-5566
(310) 227-9061
Mailing address
171 E STATE ST APT 227, ITHACA, NY 14850-5566
(310) 227-9061
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
023376-01
NY
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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