Provider Demographics
NPI:1992214365
Name:BROMMER, ALEXANDRA PAIGE
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:PAIGE
Last Name:BROMMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 TWINING RD STE 120
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1832
Mailing Address - Country:US
Mailing Address - Phone:215-254-6000
Mailing Address - Fax:215-754-1705
Practice Address - Street 1:721 DRESHER RD STE 1100
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2216
Practice Address - Country:US
Practice Address - Phone:215-254-6000
Practice Address - Fax:215-754-1705
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-28
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty