Provider Demographics
NPI:1134692205
Name:JUYA, ALEXANDRA
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:
Last Name:JUYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 PENN AVENUE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TURTLE CREEK
Mailing Address - State:PA
Mailing Address - Zip Code:15145
Mailing Address - Country:US
Mailing Address - Phone:412-824-8510
Mailing Address - Fax:
Practice Address - Street 1:519 PENN AVENUE
Practice Address - Street 2:SUITE 202
Practice Address - City:TURTLE CREEK
Practice Address - State:PA
Practice Address - Zip Code:15145
Practice Address - Country:US
Practice Address - Phone:412-824-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional