Provider Demographics
NPI:1528269024
Name:THOMPSON-DE BENOIT, ALEXINE (M S, M F T)
Entity type:Individual
Prefix:MRS
First Name:ALEXINE
Middle Name:
Last Name:THOMPSON-DE BENOIT
Suffix:
Gender:F
Credentials:M S, M F T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 ANGELES CREST HWY STE 319
Mailing Address - Street 2:
Mailing Address - City:LA CANADA
Mailing Address - State:CA
Mailing Address - Zip Code:91011-3263
Mailing Address - Country:US
Mailing Address - Phone:626-243-3771
Mailing Address - Fax:
Practice Address - Street 1:4529 ANGELES CREST HWY STE 319
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3263
Practice Address - Country:US
Practice Address - Phone:626-243-3771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44440106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist