Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 74529 | TX |
N | 225C00000X | Rehabilitation Counselor | 00120337 | IL |
NPI | 1295248318 |
---|---|
Provider Name | Mrs. Alexandra Hawarden Lambeth |
First Address | Grand Prairie, TX 75054-2273 |
Second Address | Grand Prairie, TX 75052-3308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2017 |
Last Update Date | 06/07/2020 |