Provider Demographics
NPI:1295090637
Name:MILLER, ALEXSANDRA
Entity type:Individual
Prefix:
First Name:ALEXSANDRA
Middle Name:
Last Name:MILLER
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 1:720 S LAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4561
Mailing Address - Country:US
Mailing Address - Phone:918-559-2167
Mailing Address - Fax:
Practice Address - Street 1:6418 N SANTA FE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-9112
Practice Address - Country:US
Practice Address - Phone:405-242-2242
Practice Address - Fax:405-286-1730
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional