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General NPI Number Information
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NPI Number | 1679328892
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Entity Type | Individual
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Provider Name | ALEXANDRA BECKER LGSW
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Gender | Female
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 08/17/2024
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Provider Practice Location Address
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Address Line | 11660 ROUND LAKE BLVD NW
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City | COON RAPIDS
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State | MN
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Zip | 55433-2638
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Country | US
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Telephone | 763-767-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 5105 29TH AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55417-1330
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Country | US
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Telephone | 612-458-4363
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 27218
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License Number State | MN
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