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General NPI Number Information
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NPI Number | 1992129530
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Entity Type | Individual
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Provider Name | ALEXANDRA KRASSIN
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 526 REGENCY DR STE 200
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City | LARAMIE
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State | WY
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Zip | 82070-5192
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Country | US
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Telephone | 307-314-9847
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Fax |
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Provider Business Mailing Address
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Address Line | 4989 N 3RD ST
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City | LARAMIE
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State | WY
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Zip | 82072-9548
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Country | US
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Telephone | 307-745-8997
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Fax | 307-742-6146
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PCSW-746
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-1216
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License Number State | WY
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