Healthcare Provider Details

I. General information

NPI: 1972237360
Provider Name (Legal Business Name): ALEXANDRA HUFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 INWOOD RD
DALLAS TX
75235-7320
US

IV. Provider business mailing address

2201 INWOOD RD
DALLAS TX
75235-7320
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-2742
  • Fax: 214-648-7016
Mailing address:
  • Phone: 214-645-2742
  • Fax: 214-648-7016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number41049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: