Individual
ALEXANDRA HALBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
(720) 321-0624
Mailing address
11600 W 2ND PL, LAKEWOOD, CO 80228-1527
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL0008325
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TL0008325
STATE PHYSICIAN TRAINING LICENSE
CO
Enumeration date
05/27/2020
Last updated
05/27/2020
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