Provider Demographics
NPI:1437901014
Name:ROSENDO, ALEXIS BREANAH (MA, MA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:BREANAH
Last Name:ROSENDO
Suffix:
Gender:F
Credentials:MA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-1233
Mailing Address - Country:US
Mailing Address - Phone:504-657-9143
Mailing Address - Fax:
Practice Address - Street 1:8700 PENNSYLVANIA AVE STE 3
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-2715
Practice Address - Country:US
Practice Address - Phone:412-259-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional