Provider Demographics
NPI:1386023406
Name:BOSEE, ALEXANDRA DE VALENGIN (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:DE VALENGIN
Last Name:BOSEE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N WATER ST
Mailing Address - Street 2:APT 304
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-2260
Mailing Address - Country:US
Mailing Address - Phone:203-981-6086
Mailing Address - Fax:
Practice Address - Street 1:1 N WATER ST
Practice Address - Street 2:APT 304
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-2260
Practice Address - Country:US
Practice Address - Phone:203-981-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist