Basic Information
| Provider Information | |||||||||
| NPI: | 1770964132 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HULST | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 743 HORIZON CT STE 100 | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815068715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702417600 | ||||||||
| FaxNumber: | 9702459094 | ||||||||
| Practice Location | |||||||||
| Address1: | WESTERN MEDICAL ASSOCIATES | ||||||||
| Address2: | 743 HORIZON CT STE 100 | ||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815068715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702417600 | ||||||||
| FaxNumber: | 9702459094 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 12/11/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MFT.0001383 | CO | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.