Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 24439 | TX |
Y | 103T00000X | Psychologist | 24439 | TX |
N | 103G00000X | Clinical Psychologist | 24439 | TX |
N | 103TC0700X | Clinical Psychologist | 24439 | TX |
N | 103TP2701X | Group Psychotherapist | 24439 | TX |
NPI | 1003968108 |
---|---|
Provider Name | Dr. Beverly Lynn Alexander |
First Address | Austin, TX 78748-5711 |
Second Address | Austin, TX 78748-5711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 25/09/2012 |