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General NPI Number Information
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NPI Number | 1194695775
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Entity Type | Individual
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Provider Name | ALEJANDRA HEREDIA
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Gender |
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 13343 NE BEL RED RD STE 110
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City | BELLEVUE
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State | WA
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Zip | 98005-2274
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Country | US
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Telephone | 425-679-0801
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Fax |
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Provider Business Mailing Address
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Address Line | 13343 NE BEL RED RD STE 110
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City | BELLEVUE
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State | WA
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Zip | 98005-2274
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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