| 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 |
|---|---|
| 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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