MEDICARE: ALEXANDRIA HAL

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1962844910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA HAL

Provider Business Mailing Address
First Line	:	6150 TRANSVERSE DR STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1170
Country	:	US
Telephone Number	:	702-815-0202
Fax Number	:	702-586-6645

Provider Business Practice Location Address
First Line	:	6150 TRANSVERSE DR STE 202
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-1170
Country	:	US
Telephone Number	:	702-815-0202
Fax Number	:	702-586-6645

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

Provider Enumeration Date	:	07/18/2013
Last Update Date	:	07/18/2013

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Directions to “ ALEXANDRIA HAL ” Practice Location

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