Provider Demographics
NPI:1760286116
Name:ANDERSON, ALAYJAH LESHAYE (PSYD)
Entity type:Individual
Prefix:
First Name:ALAYJAH
Middle Name:LESHAYE
Last Name:ANDERSON
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SW 78TH AVE APT 923
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3379
Mailing Address - Country:US
Mailing Address - Phone:803-260-5380
Mailing Address - Fax:
Practice Address - Street 1:7820 PETERS RD STE E100
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-4019
Practice Address - Country:US
Practice Address - Phone:954-577-0095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12703103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist