Provider Demographics
NPI:1013556117
Name:ALEXANDER FITCH, DONNA EILEEN
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:EILEEN
Last Name:ALEXANDER FITCH
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 1:1113 STONEY BEACH STREET
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-1560
Mailing Address - Country:US
Mailing Address - Phone:702-741-4861
Mailing Address - Fax:
Practice Address - Street 1:3085 S JONES BLVD
Practice Address - Street 2:STE E
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6782
Practice Address - Country:UM
Practice Address - Phone:702-200-0802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health