Provider Demographics
NPI:1619670023
Name:JACOBS, ALEXANDRA LOREN KRAMER
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LOREN KRAMER
Last Name:JACOBS
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 1:31273 LIBERTY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4519
Mailing Address - Country:US
Mailing Address - Phone:832-594-4814
Mailing Address - Fax:
Practice Address - Street 1:3131 EASTSIDE ST STE 415
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1919
Practice Address - Country:US
Practice Address - Phone:346-478-0168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107765104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker