Provider Demographics
NPI:1245782473
Name:SCHMIDT, ALEXANDRA (PHD, LP)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 28TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-3119
Mailing Address - Country:US
Mailing Address - Phone:612-605-1410
Mailing Address - Fax:612-421-0023
Practice Address - Street 1:4048 28TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-3119
Practice Address - Country:US
Practice Address - Phone:612-605-1410
Practice Address - Fax:612-421-0023
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6109103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist