Provider Demographics
NPI:1306172002
Name:POMPONIO, ALEXANDRA D'ANNUNZIO (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:D'ANNUNZIO
Last Name:POMPONIO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 CHERRY HILL LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7840
Mailing Address - Country:US
Mailing Address - Phone:610-517-1863
Mailing Address - Fax:
Practice Address - Street 1:964 CHERRY HILL LN
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7840
Practice Address - Country:US
Practice Address - Phone:610-517-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-30
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional