Healthcare Provider Details
I. General information
NPI: 1750199360
Provider Name (Legal Business Name): ALEXANDRA NADINE DUFOE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/28/2024
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 COUNTRY CLUB RD
EUGENE OR
97401-2212
US
IV. Provider business mailing address
601 COUNTRY CLUB RD APT 138
EUGENE OR
97401-2203
US
V. Phone/Fax
- Phone: 866-293-0041
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | C9899 |
| License Number State | OR |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: