Healthcare Provider Details

I. General information

NPI: 1639092851
Provider Name (Legal Business Name): ALEXANDRA PHILLIPS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 W 11TH ST APT 1
NEW YORK NY
10014-2337
US

IV. Provider business mailing address

322 W 11TH ST APT 1
NEW YORK NY
10014-2337
US

V. Phone/Fax

Practice location:
  • Phone: 412-266-1357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: