Organization
CORALYN ALEXANDER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORALYN ALEXANDER MD (OWNER)
(208) 734-3900
Entity
Organization
Contact information
Practice address
488 BLUE LAKES BLVD N, STE 102, TWIN FALLS, ID 83301-4800
(208) 734-3900
(208) 733-9463
Mailing address
PO BOX 2103, TWIN FALLS, ID 83303-2103
(208) 734-3900
(208) 733-9463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
M6940
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808649500
—
ID
Enumeration date
01/22/2007
Last updated
08/18/2010
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