Provider Demographics
NPI:1093350555
Name:ALEXANDER, ALITA E
Entity Type:Individual
Prefix:
First Name:ALITA
Middle Name:E
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 1:2418 BROWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MULBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:33860-5511
Mailing Address - Country:US
Mailing Address - Phone:813-716-6822
Mailing Address - Fax:
Practice Address - Street 1:2418 BROWNWOOD DR
Practice Address - Street 2:
Practice Address - City:MULBERRY
Practice Address - State:FL
Practice Address - Zip Code:33860-5511
Practice Address - Country:US
Practice Address - Phone:813-716-6822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor