Doctor Name: | MRS. ALEXANDRA RUNDE |
NPI Number: | 1023387651 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED. |
License Number: | MH 11040 |
Business Practice Address: | 1555 St. Lucie West Blvd. Suite 201 Port St. Lucie, FL - 34986 |
Business Phone Number: | 7728120292 |
Business Fax Number: | 7728787218 |
Mailing Address: | 1555 St. Lucie West Blvd., Suite 201 PORT ST. LUCIE |
State: | FL |
Postal Code: | 34986 |
Phone Number: | 7728120292 |
Fax Number: | 7728787218 |
NPI Enumeration Date: | 12/28/2011 |
NPI Last Update Date: | 02/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH 11040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |