Provider Demographics
NPI:1124395181
Name:RAYMOND, ALIXANDRA NICOLE (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ALIXANDRA
Middle Name:NICOLE
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:ALIXANDRA
Other - Middle Name:RAYMOND
Other - Last Name:HUBBARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:1980 OLD CEDARTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CEDARTOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30125-5082
Mailing Address - Country:US
Mailing Address - Phone:678-787-8039
Mailing Address - Fax:
Practice Address - Street 1:1980 OLD CEDARTOWN RD
Practice Address - Street 2:
Practice Address - City:CEDARTOWN
Practice Address - State:GA
Practice Address - Zip Code:30125-5082
Practice Address - Country:US
Practice Address - Phone:386-283-3705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018556100Medicaid