Provider Demographics
NPI:1316290810
Name:HAMMOURI, ALEXANDRA (PSY D)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:HAMMOURI
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSY D
Mailing Address - Street 1:727 S FAYETTEVILLE ST STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-6578
Mailing Address - Country:US
Mailing Address - Phone:336-625-2073
Mailing Address - Fax:336-625-2737
Practice Address - Street 1:727 S FAYETTEVILLE ST STE C
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6578
Practice Address - Country:US
Practice Address - Phone:336-625-2073
Practice Address - Fax:336-625-2737
Is Sole Proprietor?:No
Enumeration Date:2012-10-21
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4290103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC175HUOtherBCBSNC
NC175HUOtherBCBSNC