Provider Demographics
NPI:1023372307
Name:ALEXANDER, JUDITH ANN (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6633 YORK ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3586
Mailing Address - Country:US
Mailing Address - Phone:817-319-4705
Mailing Address - Fax:
Practice Address - Street 1:2700 AIRPORT FWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-2332
Practice Address - Country:US
Practice Address - Phone:817-332-6329
Practice Address - Fax:817-332-2828
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-01
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12512101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional