Provider Demographics
NPI:1376344069
Name:HERNANDEZ DE LA ROSA, ANYELINA M (LPC-A)
Entity type:Individual
Prefix:
First Name:ANYELINA
Middle Name:M
Last Name:HERNANDEZ DE LA ROSA
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 N PARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1342
Mailing Address - Country:US
Mailing Address - Phone:484-709-1381
Mailing Address - Fax:
Practice Address - Street 1:845 N PARK RD
Practice Address - Street 2:STE 101
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1342
Practice Address - Country:US
Practice Address - Phone:484-709-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001062101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional