Provider Demographics
NPI:1144603069
Name:YRAGUI, ALEX MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:ALEX
Middle Name:MARIE
Last Name:YRAGUI
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 1:1633 CAMINO LA CANADA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2324
Mailing Address - Country:US
Mailing Address - Phone:949-751-9185
Mailing Address - Fax:
Practice Address - Street 1:1692 HOSPITAL DR
Practice Address - Street 2:BUILDING B, SUITE 101
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4754
Practice Address - Country:US
Practice Address - Phone:505-984-2560
Practice Address - Fax:505-989-3841
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMGC2015-013170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS