Healthcare Provider Details

I. General information

NPI: 1235710229
Provider Name (Legal Business Name): ALEXANDRA MOSSER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 04/20/2021
Certification Date: 04/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 LONG RUN RD
MCKEESPORT PA
15132-7449
US

IV. Provider business mailing address

633 LONG RUN RD
MCKEESPORT PA
15132-7449
US

V. Phone/Fax

Practice location:
  • Phone: 412-751-5280
  • Fax: 412-751-5530
Mailing address:
  • Phone: 412-751-5280
  • Fax: 412-751-5530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC013161
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: