MEDICARE: AMY ALEXANDER LPC

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
1	101YP2500X	Professional Counselor	61250	TX

General Provider Information

NPI Number	:	1720316151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ALEXANDER LPC

Provider Business Mailing Address
First Line	:	7601 RIALTO BLVD APT 2033
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-7433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7601 RIALTO BLVD APT 2033
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-7433
Country	:	US
Telephone Number	:	512-968-3889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	11/23/2009

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Directions to “ AMY ALEXANDER LPC” Practice Location

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