Alexander Professional | |
2633 State Route 59 Suite E Ravenna OH 44266-1684 | |
(330) 296-2829 | |
(330) 541-2732 |
Full Name | Alexander Professional |
---|---|
Speciality | Psychologist - Clinical |
Location | 2633 State Route 59, Ravenna, Ohio |
Authorized Official Name and Position | John Edward Alexander (OWNER) |
Authorized Official Contact | 3302962809 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Alexander Professional Po Box 1474 Kent OH 44240-0028 Ph: (330) 296-2809 | Alexander Professional 2633 State Route 59 Suite E Ravenna OH 44266-1684 Ph: (330) 296-2829 |
NPI Number | 1740387828 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 04/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740387828 | NPI | - | NPPES |
0450962 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 3504 (Ohio) | Primary |
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