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NPI Code Detail

MEDICARE: MS. HOLLY LOUISE ALEXANDER PCC

MEDICARE: MS. HOLLY LOUISE ALEXANDER PCC
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
1101YP2500XProfessional CounselorE. 0004136OH

General Provider Information

NPI Number : 1700057247
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HOLLY LOUISE ALEXANDER PCC
Provider Business Mailing Address
First Line : 104 SPINK ST
Second Line : GAULT LIBERTY CENTER
City : WOOSTER
State : OH
Zip : 44691-3652
Country : US
Telephone Number : 330-263-6021
Fax Number : 330-262-6245
Provider Business Practice Location Address
First Line : 104 SPINK ST
Second Line : GAULT LIBERTY CENTER
City : WOOSTER
State : OH
Zip : 44691-3652
Country : US
Telephone Number : 330-263-6021
Fax Number : 330-262-6245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2008
Last Update Date : 03/12/2008

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