Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 76033 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 76033 | TX |
N | 101YM0800X | Mental Health Counselor | 76033 | TX |
N | 101YP2500X | Professional Counselor | 76033 | TX |
Y | 103TC1900X | Counseling Psychologist | 76033 | TX |
N | 103TP2701X | Group Psychotherapist | 76033 | TX |
N | 103TR0400X | Rehabilitation Psychologist | 76033 | TX |
NPI | 1770082885 |
---|---|
Provider Name | Dr. Billy Alexander JR. |
First Address | Weatherford, TX 76087-4055 |
Second Address | Weatherford, TX 76087-4055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2018 |
Last Update Date | 04/02/2018 |