Provider Demographics
NPI:1336325075
Name:ALEXANDER, JACQUELINE RUTH (PHD-LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:RUTH
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PHD-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S KOBAYASHI
Mailing Address - Street 2:#611
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4823
Mailing Address - Country:US
Mailing Address - Phone:281-554-9858
Mailing Address - Fax:
Practice Address - Street 1:901 S KOBAYASHI
Practice Address - Street 2:#611
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4823
Practice Address - Country:US
Practice Address - Phone:281-554-9858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical