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General NPI Number Information
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NPI Number | 1235938853
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Entity Type | Individual
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Provider Name | ALEXANDER F RODING PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2025
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Last Update Date | 03/08/2025
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Provider Practice Location Address
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Address Line | 11050 MT BELVEDERE BLVD
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City | FORT DRUM
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State | NY
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Zip | 13602-2603
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Country | US
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Telephone | 267-400-2769
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Fax |
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Provider Business Mailing Address
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Address Line | 721 BRENTWINDS LN APT 102
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City | SPRING LAKE
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State | NC
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Zip | 28390-2188
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Country | US
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Telephone | 267-400-2769
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008567
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License Number State | VA
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