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General NPI Number Information
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NPI Number | 1982981742
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Entity Type | Individual
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Provider Name | ALEXANDRA DAWN PETERS M.ED., LPCC-S
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Gender | Female
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 07/19/2022
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Provider Practice Location Address
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Address Line | 4835 POPLAR LEVEL RD STE 110
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City | LOUISVILLE
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State | KY
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Zip | 40213-2906
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Country | US
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Telephone | 859-780-3019
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | LONDON
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State | KY
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Zip | 40743-1027
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 168322
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License Number State | KY
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