Provider Demographics
NPI:1053594770
Name:LEEDY, ALEXANDRIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:
Last Name:LEEDY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:
Other - Last Name:PIERINI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:95-390 KUAHELANI AVE STE 3AC
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1190
Mailing Address - Country:US
Mailing Address - Phone:808-672-2024
Mailing Address - Fax:
Practice Address - Street 1:1050 QUEEN ST STE 100
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4130
Practice Address - Country:US
Practice Address - Phone:808-672-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21744103T00000X, 103TA0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging