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General NPI Number Information
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NPI Number | 1629601893
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Entity Type | Individual
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Provider Name | ALEXIS PAICE WINEGAR
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Gender | Female
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 20 W MARKET ST
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City | LEESBURG
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State | VA
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Zip | 20176-2805
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Country | US
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Telephone | 571-271-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 533 EDMONTON TER NE
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City | LEESBURG
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State | VA
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Zip | 20176-1822
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Country | US
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Telephone | 571-271-1763
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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 | 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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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701012804
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License Number State | VA
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