Individual
DEMITRA ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 BUECHEL AVE BLDG 3, LOUISVILLE, KY 40218-2658
(502) 442-5720
Mailing address
PO BOX 16046, LOUISVILLE, KY 40256-0046
(502) 424-5720
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
225600000X
Dance Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
KY
373H00000X
Day Training/Habilitation Specialist
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
KY
Other
Enumeration date
03/20/2017
Last updated
09/03/2020
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