Provider Demographics
NPI:1306602024
Name:HERRERA, ALEXANDRA (MFT MS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:MFT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2661 S COURSE DR APT 804
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-3947
Mailing Address - Country:US
Mailing Address - Phone:954-205-5653
Mailing Address - Fax:
Practice Address - Street 1:351 S CYPRESS RD
Practice Address - Street 2:# 210G
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060
Practice Address - Country:US
Practice Address - Phone:954-205-5653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT3626106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist