Doctor Name: | ALIX DUSEL |
NPI Number: | 1033485792 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 36 East Ave Ste E Lockport, NY - 140943727 |
Business Phone Number: | 7164332484 |
Business Fax Number: | |
Mailing Address: | 3020 Bailey Ave, BUFFALO |
State: | NY |
Postal Code: | 142152814 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/28/2012 |
NPI Last Update Date: | 03/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |