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General NPI Number Information
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NPI Number | 1164912440
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Entity Type | Individual
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Provider Name | DANIELLE ALEXANDER
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Gender | Female
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Dates
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Enumeration Date | 05/13/2018
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 60 REVERE DR
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City | NORTHBROOK
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State | IL
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Zip | 60062-1563
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Country | US
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Telephone | 224-306-1879
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Fax |
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Provider Business Mailing Address
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Address Line | 725 72ND ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60516-3940
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Country | US
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Telephone |
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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 | 180.012622
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License Number State | IL
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