Provider Demographics
NPI:1275634776
Name:ALEXANDER, PATRICIA MARIE (LCPC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:MARIE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3466 S PIMMIT PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-6427
Mailing Address - Country:US
Mailing Address - Phone:208-724-2448
Mailing Address - Fax:208-426-0464
Practice Address - Street 1:410 S ORCHARD ST
Practice Address - Street 2:SUITE 132
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1260
Practice Address - Country:US
Practice Address - Phone:208-724-2448
Practice Address - Fax:208-426-0464
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC42101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional