Provider Demographics
NPI:1881746915
Name:ROBERTSON, ALEXANDER DENNIS (BSW BACHELOR OF SOCI)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:DENNIS
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:BSW BACHELOR OF SOCI
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 1183
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965
Mailing Address - Country:US
Mailing Address - Phone:530-518-3124
Mailing Address - Fax:
Practice Address - Street 1:107 PARMAC ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-891-2964
Practice Address - Fax:530-895-6683
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor