Provider Demographics
NPI:1023558772
Name:SHALIT, ALEXA (MED)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:SHALIT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CALLISON LN
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4111
Mailing Address - Country:US
Mailing Address - Phone:856-304-3478
Mailing Address - Fax:
Practice Address - Street 1:342 EGG HARBOR RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1856
Practice Address - Country:US
Practice Address - Phone:856-589-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor