Healthcare Provider Details

I. General information

NPI: 1932675238
Provider Name (Legal Business Name): ALEXANDRA M ANZALONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 METAIRIE RD STE 515
METAIRIE LA
70005-4326
US

IV. Provider business mailing address

433 METAIRIE RD
METAIRIE LA
70005-4333
US

V. Phone/Fax

Practice location:
  • Phone: 504-833-6730
  • Fax: 504-833-6731
Mailing address:
  • Phone: 504-833-6730
  • Fax: 504-833-6731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-81354
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: