Provider Demographics
NPI:1053410399
Name:WOLSON, ALICE KANE (DSW)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:KANE
Last Name:WOLSON
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 E 87TH ST APT 10D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0582
Mailing Address - Country:US
Mailing Address - Phone:212-426-2609
Mailing Address - Fax:
Practice Address - Street 1:2 BRAMBACH AVENUE
Practice Address - Street 2:
Practice Address - City:SCARSDALE,
Practice Address - State:NY
Practice Address - Zip Code:10184
Practice Address - Country:US
Practice Address - Phone:914-723-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR017473-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health