Healthcare Provider Details

I. General information

NPI: 1790093714
Provider Name (Legal Business Name): ERIN A. ALEXANDER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2010
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 MED CT STE 106
SAN ANTONIO TX
78258-3483
US

IV. Provider business mailing address

7113 SAN PEDRO AVE # 266
SAN ANTONIO TX
78216-6219
US

V. Phone/Fax

Practice location:
  • Phone: 210-495-0675
  • Fax: 210-495-0884
Mailing address:
  • Phone: 210-232-2804
  • Fax: 866-936-1664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number18193
License Number StateTX

VIII. Authorized Official

Name: MS. ERIN ALAINE ALEXANDER
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: MA
Phone: 210-232-2804