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General NPI Number Information
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NPI Number | 1861213761
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Entity Type | Individual
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Provider Name | KRISTEN ALEXANDER PSY.S
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 1283 S MAIN ST
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City | WOLF LAKE
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State | IN
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Zip | 46796
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Country | US
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Telephone | 260-635-2432
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Fax |
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Provider Business Mailing Address
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Address Line | 1283 S MAIN STREET
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City | WOLF LAKE
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State | IN
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Zip | 46796
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Country | US
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Telephone | 260-635-2432
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Fax | 260-635-2327
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10247226
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License Number State | IN
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