Provider Demographics
NPI:1770964132
Name:HULST, ALEXANDRA (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:HULST
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 HORIZON CT STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8715
Mailing Address - Country:US
Mailing Address - Phone:970-241-7600
Mailing Address - Fax:970-245-9094
Practice Address - Street 1:WESTERN MEDICAL ASSOCIATES
Practice Address - Street 2:743 HORIZON CT STE 100
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8715
Practice Address - Country:US
Practice Address - Phone:970-241-7600
Practice Address - Fax:970-245-9094
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001383106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist