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General NPI Number Information
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NPI Number | 1316453640
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Entity Type | Individual
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Provider Name | ALEXANDRIA ROSE PERLE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 930 CHESTNUT RIDGE RD
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City | MORGANTOWN
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State | WV
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Zip | 26505-2807
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Country | US
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Telephone | 304-598-4214
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Fax |
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Provider Business Mailing Address
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Address Line | 1952 CARLSBAD CIR APT 107
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City | NAPERVILLE
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State | IL
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Zip | 60563-8853
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Country | US
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Telephone | 805-407-4682
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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 | 071.009693
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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