Provider Demographics
NPI:1194945436
Name:ALEXANDER, ROBERT BRUCE (PHD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 702
Mailing Address - Street 2:25 SQUANTO RD
Mailing Address - City:NORTH EASTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02651-0702
Mailing Address - Country:US
Mailing Address - Phone:508-255-8273
Mailing Address - Fax:
Practice Address - Street 1:25 SQUANTO RD
Practice Address - Street 2:
Practice Address - City:NORTH EASTHAM
Practice Address - State:MA
Practice Address - Zip Code:02651-0702
Practice Address - Country:US
Practice Address - Phone:508-255-8273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2699103TA0400X, 103TB0200X, 103TC0700X, 103TF0200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy