Provider Demographics
NPI:1679919922
Name:ALEXANDER, DENISE VICTORIA (MA)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:VICTORIA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:DENISE
Other - Middle Name:VICTORIA
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:3109 LOST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-4858
Mailing Address - Country:US
Mailing Address - Phone:251-421-8248
Mailing Address - Fax:
Practice Address - Street 1:2711 W 15TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-1366
Practice Address - Country:US
Practice Address - Phone:850-769-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health