Individual
ALEXANDER BASCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
Mailing address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC03524
MN
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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