Healthcare Provider Details

I. General information

NPI: 1487416632
Provider Name (Legal Business Name): CARA ALEXANDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4075 PARK AVE
MEMPHIS TN
38111-7400
US

IV. Provider business mailing address

395 S HIGHLAND ST APT 110
MEMPHIS TN
38111-1588
US

V. Phone/Fax

Practice location:
  • Phone: 901-584-8281
  • Fax:
Mailing address:
  • Phone: 815-564-8468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: