Provider Demographics
NPI:1497091458
Name:MCCALLEN, ALEXANDRA FLORENCE (M ED, BCBA)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:FLORENCE
Last Name:MCCALLEN
Suffix:
Gender:F
Credentials:M ED, BCBA
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:FLORENCE
Other - Last Name:CHEHAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16850 SW LEDGESTONE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-5189
Mailing Address - Country:US
Mailing Address - Phone:971-425-1014
Mailing Address - Fax:
Practice Address - Street 1:16850 SW LEDGESTONE DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-5189
Practice Address - Country:US
Practice Address - Phone:971-425-1014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-09-5007103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst