Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 20010393A | IN |
Y | 103T00000X | Psychologist | 20010393A | IN |
NPI | 1013062918 |
---|---|
Provider Name | Dr. William D. Alexy |
First Address | Indianapolis, IN 46208 |
Second Address | Indianapolis, IN 46208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20700620A | FIRST STEPS (01) | IN |