Provider Demographics
NPI:1245632256
Name:ALEXANDER, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ALEXANDER
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:PO BOX 1220
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-1220
Mailing Address - Country:US
Mailing Address - Phone:808-870-4304
Mailing Address - Fax:
Practice Address - Street 1:161 WAILEA IKE PLACE
Practice Address - Street 2:SUITE A105
Practice Address - City:WAILEA
Practice Address - State:HI
Practice Address - Zip Code:96753
Practice Address - Country:US
Practice Address - Phone:808-870-4304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health