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NPI Code Detail

MEDICARE: ALEXA WILT

MEDICARE: ALEXA WILT
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
1101Y00000XCounselor
2175T00000XPeer SpecialistWA

General Provider Information

NPI Number : 1861042426
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA WILT
Provider Business Mailing Address
First Line : 10505 W CLEARWATER AVE
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-8613
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10505 W CLEARWATER AVE
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-8613
Country : US
Telephone Number : 509-572-7844
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2019
Last Update Date : 04/13/2026

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Directions to “ ALEXA WILT ” Practice Location

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