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General NPI Number Information
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NPI Number | 1710525076
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Entity Type | Individual
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Provider Name | ALEXANDRA LYNN GRZYWNA M.S.ED, LMHC-P
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Gender | Female
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Dates
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Enumeration Date | 12/18/2019
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Last Update Date | 05/15/2024
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Provider Practice Location Address
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Address Line | 20 RICH ST
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City | BUFFALO
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State | NY
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Zip | 14211-3020
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Country | US
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Telephone | 716-895-7715
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Fax |
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Provider Business Mailing Address
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Address Line | 608 CRESCENT AVE
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City | EAST AURORA
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State | NY
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Zip | 14052-2904
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Country | US
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Telephone | 716-207-0278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 18-P117114-01
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License Number State | NY
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