Provider Demographics
NPI:1427773134
Name:METHE, ALEXANDRA GERMAINE
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:GERMAINE
Last Name:METHE
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 1:3 ALCOVE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHWICK
Mailing Address - State:MA
Mailing Address - Zip Code:01077-9808
Mailing Address - Country:US
Mailing Address - Phone:413-316-0007
Mailing Address - Fax:
Practice Address - Street 1:3 ALCOVE RD
Practice Address - Street 2:
Practice Address - City:SOUTHWICK
Practice Address - State:MA
Practice Address - Zip Code:01077-9808
Practice Address - Country:US
Practice Address - Phone:413-316-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARBT-22-234672106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician