Provider Demographics
NPI:1578348140
Name:KRIOFSKE MAINELLA, ALEXANDRA M (PHD, CRC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:M
Last Name:KRIOFSKE MAINELLA
Suffix:
Gender:F
Credentials:PHD, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 N 55TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2102
Mailing Address - Country:US
Mailing Address - Phone:414-405-2151
Mailing Address - Fax:
Practice Address - Street 1:1315 N 55TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53208-2102
Practice Address - Country:US
Practice Address - Phone:414-405-2151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health