Provider Demographics
NPI:1871237065
Name:ALEXANDER, TOM JR
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:
Last Name:ALEXANDER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12649 LEMASTER DR
Mailing Address - Street 2:
Mailing Address - City:NOKESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20181-2442
Mailing Address - Country:US
Mailing Address - Phone:601-212-8428
Mailing Address - Fax:
Practice Address - Street 1:12649 LEMASTER DR
Practice Address - Street 2:
Practice Address - City:NOKESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20181-2442
Practice Address - Country:US
Practice Address - Phone:601-212-8428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-24
Last Update Date:2022-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor