Individual
ALVINA TAKISHA MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
Mailing address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 542-8770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38846
NY
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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