Provider Demographics
NPI:1184887390
Name:MAGALNICK, ALICE MICHELE (LMFT)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:MICHELE
Last Name:MAGALNICK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:MICHELE
Other - Last Name:MALACHOWSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:MILL HILL MEDICAL CONSULTANTS INC
Mailing Address - Street 2:PO BOX 415126
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-0001
Mailing Address - Country:US
Mailing Address - Phone:203-384-3394
Mailing Address - Fax:203-384-3829
Practice Address - Street 1:226 MILL HILL AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2826
Practice Address - Country:US
Practice Address - Phone:203-384-3394
Practice Address - Fax:203-384-3829
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000964106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist