Provider Demographics
NPI:1043904410
Name:ALEXANDER, DANTE RACHELLE
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:RACHELLE
Last Name:ALEXANDER
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 1:15574 EDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56401-6955
Mailing Address - Country:US
Mailing Address - Phone:218-829-2665
Mailing Address - Fax:
Practice Address - Street 1:15574 EDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56401-6955
Practice Address - Country:US
Practice Address - Phone:218-829-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist