Basic Information
| Provider Information | |||||||||
| NPI: | 1437698461 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | CORI | ||||||||
| MiddleName: | DANIELLE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LAC, LAMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2607 CADDO ST STE 6 | ||||||||
| Address2: | |||||||||
| City: | ARKADELPHIA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719235307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702308217 | ||||||||
| FaxNumber: | 8709339395 | ||||||||
| Practice Location | |||||||||
| Address1: | 321 E 13TH ST | ||||||||
| Address2: | |||||||||
| City: | MURFREESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719589541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702853699 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2017 | ||||||||
| LastUpdateDate: | 01/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | F1701001 | AR | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 101Y00000X | A1701172 | AR | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.