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General NPI Number Information
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NPI Number | 1275634776
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Entity Type | Individual
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Provider Name | PATRICIA MARIE ALEXANDER LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 410 S ORCHARD ST SUITE 132
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City | BOISE
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State | ID
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Zip | 83705-1260
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Country | US
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Telephone | 208-724-2448
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Fax | 208-426-0464
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Provider Business Mailing Address
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Address Line | 3466 S PIMMIT PL
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City | BOISE
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State | ID
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Zip | 83706-6427
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Country | US
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Telephone | 208-724-2448
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Fax | 208-426-0464
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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 | LCPC42
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License Number State | ID
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