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Organization

ALEXANDER PROFESSIONAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN EDWARD ALEXANDER PH.D (OWNER)
(330) 296-2809
Entity
Organization

Contact information

Practice address
2633 STATE ROUTE 59, SUITE E, RAVENNA, OH 44266-1684
(330) 296-2829
(330) 541-2732
Mailing address
PO BOX 1474, KENT, OH 44240-0028
(330) 296-2809
(330) 296-2800

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3504
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0450962
OH
Enumeration date
09/20/2006
Last updated
04/14/2008
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