Healthcare Provider Details

I. General information

NPI: 1134692205
Provider Name (Legal Business Name): MS. ALEXANDRA JUYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 PENN AVENUE SUITE 202
TURTLE CREEK PA
15145
US

IV. Provider business mailing address

519 PENN AVENUE SUITE 202
TURTLE CREEK PA
15145
US

V. Phone/Fax

Practice location:
  • Phone: 412-824-8510
  • Fax:
Mailing address:
  • Phone: 412-824-8510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010977
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: