Provider Demographics
NPI:1922356302
Name:RELYEA-NIEMANN, ALEXIS MARIE
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:MARIE
Last Name:RELYEA-NIEMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:MARIE
Other - Last Name:RELYEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3791
Mailing Address - Country:US
Mailing Address - Phone:860-313-1119
Mailing Address - Fax:
Practice Address - Street 1:45 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3791
Practice Address - Country:US
Practice Address - Phone:860-313-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-16
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist