Healthcare Provider Details

I. General information

NPI: 1497087985
Provider Name (Legal Business Name): ALEXANDRA DEAN PHD, NCC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 COX RD
GASTONIA NC
28054-0628
US

IV. Provider business mailing address

549 COX RD
GASTONIA NC
28054
UM

V. Phone/Fax

Practice location:
  • Phone: 704-852-3778
  • Fax:
Mailing address:
  • Phone: 704-852-3778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8575
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: