Provider Demographics
NPI:1316194152
Name:ZORNITTA, ALEXIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:
Last Name:ZORNITTA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11815 FOUNTAIN WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4448
Mailing Address - Country:US
Mailing Address - Phone:757-335-6485
Mailing Address - Fax:
Practice Address - Street 1:11815 FOUNTAIN WAY STE 300
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4448
Practice Address - Country:US
Practice Address - Phone:757-335-6485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-23
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004879103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical