Basic Information
| Provider Information | |||||||||
| NPI: | 1831532209 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MESSINA | ||||||||
| FirstName: | XIOMARA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 537 E ALLEGHENY AVE | ||||||||
| Address2: | APT/SUITE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191342328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152919500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 537 E ALLEGHENY AVE | ||||||||
| Address2: | APT/SUITE | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191342328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152919500 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2013 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.