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General NPI Number Information
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NPI Number | 1124689146
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Entity Type | Individual
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Provider Name | ALEXANDRA DEVINE YARMULNIK LPC
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 6213 N GREEN BAY AVE
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City | GLENDALE
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State | WI
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Zip | 53209-3823
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Country | US
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Telephone | 414-235-7443
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Fax |
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Provider Business Mailing Address
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Address Line | 5726 S 113TH ST
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City | HALES CORNERS
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State | WI
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Zip | 53130-1806
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Country | US
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Telephone | 414-791-3130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4377226
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License Number State | WI
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