Provider Demographics
NPI:1326741745
Name:CASTRE, ALEXANDRA
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CASTRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SHAKER LN
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-1147
Mailing Address - Country:US
Mailing Address - Phone:205-470-8447
Mailing Address - Fax:
Practice Address - Street 1:201 SHAKER LN
Practice Address - Street 2:
Practice Address - City:MIDLAND CITY
Practice Address - State:AL
Practice Address - Zip Code:36350-1147
Practice Address - Country:US
Practice Address - Phone:205-470-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
AL1-24-74952103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician