Provider Demographics
NPI:1205404365
Name:FULL, ALEXA RENEE
Entity Type:Individual
Prefix:MISS
First Name:ALEXA
Middle Name:RENEE
Last Name:FULL
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 1:509 E END AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-3231
Mailing Address - Country:US
Mailing Address - Phone:724-766-6351
Mailing Address - Fax:
Practice Address - Street 1:11279 PERRY HWY STE 500
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9303
Practice Address - Country:US
Practice Address - Phone:724-933-1000
Practice Address - Fax:724-933-1010
Is Sole Proprietor?:No
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health