Healthcare Provider Details

I. General information

NPI: 1184540924
Provider Name (Legal Business Name): ALEXANDER DOVE HYACINTH ROSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 GREENWAY BLVD
MIDDLETON WI
53562-4713
US

IV. Provider business mailing address

1322 E WASHINGTON AVE APT 515
MADISON WI
53703-3081
US

V. Phone/Fax

Practice location:
  • Phone: 608-516-1734
  • Fax:
Mailing address:
  • Phone: 321-514-0223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: