Provider Demographics
NPI:1396921433
Name:COLVIN, ALEXANDRA ANDERSON (MS)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ANDERSON
Last Name:COLVIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:ALEXANDRA
Other - Middle Name:SKINNER
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1411 NIGHTINGALE WAY
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-5668
Mailing Address - Country:US
Mailing Address - Phone:541-517-0095
Mailing Address - Fax:
Practice Address - Street 1:4490 HOLLAND OFFICE PARK
Practice Address - Street 2:STE 101
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1177
Practice Address - Country:US
Practice Address - Phone:757-639-2218
Practice Address - Fax:866-594-3899
Is Sole Proprietor?:No
Enumeration Date:2008-01-19
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst