Provider Demographics
NPI:1033491105
Name:SPANN, ALEXANDRIA MATTEAU (MS)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:MATTEAU
Last Name:SPANN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-2235
Mailing Address - Country:US
Mailing Address - Phone:615-460-4120
Mailing Address - Fax:615-279-6702
Practice Address - Street 1:2400 WHITE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2235
Practice Address - Country:US
Practice Address - Phone:615-460-4120
Practice Address - Fax:615-279-6702
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health