Provider Demographics
NPI:1952595845
Name:ALEXANDER, ROBYN DEEGAN (LPC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:DEEGAN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 NEVADA CIR
Mailing Address - Street 2:APARTMENT 4
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-6587
Mailing Address - Country:US
Mailing Address - Phone:801-623-1966
Mailing Address - Fax:801-623-4340
Practice Address - Street 1:1990 NEVADA CIR
Practice Address - Street 2:APARTMENT 4
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-6587
Practice Address - Country:US
Practice Address - Phone:801-623-1966
Practice Address - Fax:801-623-4340
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT310391-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT02271965Medicaid