| Doctor Name: | MS. ALICE MADISON JAX |
| NPI Number: | 1467785279 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPCC |
| License Number: | 0137461 |
| Business Practice Address: | 1535 N. Main Lovington, NM - 88260 |
| Business Phone Number: | 5753968899 |
| Business Fax Number: | |
| Mailing Address: | 2669 Scenic Dr, Gerald Champion Regional Medical Center ALAMOGORDO |
| State: | NM |
| Postal Code: | 883108700 |
| Phone Number: | 5754465300 |
| Fax Number: | 5754465304 |
| NPI Enumeration Date: | 09/10/2009 |
| NPI Last Update Date: | 12/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0137461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |