Provider Demographics
NPI:1306587696
Name:AJEL, ALIAA I
Entity type:Individual
Prefix:MS
First Name:ALIAA
Middle Name:
Last Name:AJEL
Suffix:I
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALIAA
Other - Middle Name:
Other - Last Name:AJEL
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504-1522
Mailing Address - Country:US
Mailing Address - Phone:814-580-6522
Mailing Address - Fax:
Practice Address - Street 1:110 E 37TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504-1522
Practice Address - Country:US
Practice Address - Phone:814-580-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009064101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional