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NPI Code Detail

MEDICARE: ALEXA BUCKMON

MEDICARE: ALEXA BUCKMON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1336862796
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA BUCKMON
Provider Business Mailing Address
First Line : 224 W 35TH ST STE 500
Second Line :
City : NEW YORK
State : NY
Zip : 10001-2538
Country : US
Telephone Number : 833-646-3222
Fax Number : 833-646-3222
Provider Business Practice Location Address
First Line : 2240 BUSH DR STE 200
Second Line :
City : MCKINNEY
State : TX
Zip : 75070-7547
Country : US
Telephone Number : 833-646-3222
Fax Number : 833-646-3222
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2022
Last Update Date : 09/21/2022

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Directions to “ ALEXA BUCKMON ” Practice Location

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