Provider Demographics
NPI:1346416328
Name:ALEXANDER, KATHY PAULINE (EDS)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:PAULINE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 SUZZANNE WAY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-7924
Mailing Address - Country:US
Mailing Address - Phone:859-322-7623
Mailing Address - Fax:
Practice Address - Street 1:254 SUZZANNE WAY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-7924
Practice Address - Country:US
Practice Address - Phone:859-282-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172V00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1486OtherFIRST STEPS PROVIDER NUMBER