Provider Demographics
NPI:1366014870
Name:HOGREFE, ALEXIS PAIGE
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:PAIGE
Last Name:HOGREFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 GLENN RD NW
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4007
Mailing Address - Country:US
Mailing Address - Phone:320-219-7644
Mailing Address - Fax:
Practice Address - Street 1:59 GLENN RD NW
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4007
Practice Address - Country:US
Practice Address - Phone:320-219-7644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician