Basic Information
| Provider Information | |||||||||
| NPI: | 1851987887 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | JONESHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 63 ROBIN HOOD RD | ||||||||
| Address2: | |||||||||
| City: | DRY PRONG | ||||||||
| State: | LA | ||||||||
| PostalCode: | 714233547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2543504555 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3600 JACKSON ST STE 119 | ||||||||
| Address2: | |||||||||
| City: | ALEXANDRIA | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713033096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186257050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2020 | ||||||||
| LastUpdateDate: | 12/14/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.