Provider Demographics
NPI:1982251476
Name:O'GRADY, ALEXANDRA CHRISTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:CHRISTINE
Last Name:O'GRADY
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 1:154 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-1356
Mailing Address - Country:US
Mailing Address - Phone:908-418-3793
Mailing Address - Fax:
Practice Address - Street 1:154 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-1356
Practice Address - Country:US
Practice Address - Phone:908-418-3793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-20894103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst