Doctor Name: | ALEXANDRA ROEGIERS |
NPI Number: | 1376985804 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 21 Tamal Vista Blvd Suite 187 Corte Madera, CA - 949251130 |
Business Phone Number: | 4154134656 |
Business Fax Number: | |
Mailing Address: | 21 Tamal Vista Blvd, Suite 187 CORTE MADERA |
State: | CA |
Postal Code: | 949251130 |
Phone Number: | 4154134656 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2013 |
NPI Last Update Date: | 09/22/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |