Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 0004929 | CO |
N | 103T00000X | Psychologist | 0004929 | CO |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY.0004929 | CO |
NPI | 1063791861 |
---|---|
Provider Name | Dr. Alexandra Maria Alfonso |
First Address | Aurora, CO 80042-0429 |
Second Address | Aurora, CO 80045-7106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2011 |
Last Update Date | 08/12/2018 |