Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 2768 | TN |
Y | 101YM0800X | Mental Health Counselor | 2768 | TN |
NPI | 1003184987 |
---|---|
Provider Name | Mari Antoinette Alexander |
First Address | Gallatin, TN 37066-6036 |
Second Address | Hendersonville, TN 37075-3883 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2011 |
Last Update Date | 15/06/2020 |