Provider Demographics
NPI:1760760342
Name:ROGERS-ALEXANDER, TIFFANY MARIA (LPC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIA
Last Name:ROGERS-ALEXANDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:MARIA
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:2839 CULVER RD STE 202A
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2331
Mailing Address - Country:US
Mailing Address - Phone:205-908-5501
Mailing Address - Fax:
Practice Address - Street 1:2839 CULVER RD STE 202A
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2331
Practice Address - Country:US
Practice Address - Phone:205-908-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional