Basic Information
| Provider Information | |||||||||
| NPI: | 1205468477 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALTOPP-MILLER | ||||||||
| FirstName: | SHELLI | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | NAPLES | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145129555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362687164 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1126 BALD HILL RD | ||||||||
| Address2: | |||||||||
| City: | HORNELL | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148431262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6073247880 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2020 | ||||||||
| LastUpdateDate: | 02/06/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 089303 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.