Provider Demographics
NPI:1427793843
Name:VELLA, ALEXA LEANNE (NBC-HWC, CTRS, BCNC)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:LEANNE
Last Name:VELLA
Suffix:
Gender:F
Credentials:NBC-HWC, CTRS, BCNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 1ST ST APT 2
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3318
Mailing Address - Country:US
Mailing Address - Phone:908-591-4027
Mailing Address - Fax:
Practice Address - Street 1:306 1ST ST # 2
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3318
Practice Address - Country:US
Practice Address - Phone:908-591-4027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40526NC133N00000X
NJ61687225800000X
NJA-3252826171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist