Healthcare Provider Details

I. General information

NPI: 1326708389
Provider Name (Legal Business Name): ALISHA RITA MARCHEGIANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S WASHINGTON AVE
SCRANTON PA
18505-3814
US

IV. Provider business mailing address

1108 SAND ST
JESSUP PA
18434-1731
US

V. Phone/Fax

Practice location:
  • Phone: 570-941-0630
  • Fax:
Mailing address:
  • Phone: 570-766-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014087
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: