Provider Demographics
NPI:1831602440
Name:BRANDT, ALEXANDER REED
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:REED
Last Name:BRANDT
Suffix:
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 1:3232 WOLCOTT CIR # 2
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1522
Mailing Address - Country:US
Mailing Address - Phone:916-214-6149
Mailing Address - Fax:
Practice Address - Street 1:3232 WOLCOTT CIR # 2
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1522
Practice Address - Country:US
Practice Address - Phone:916-214-6149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician