Provider Demographics
NPI:1528846490
Name:HOPKINS, ALECSANDRIA SHAR (LMT)
Entity type:Individual
Prefix:
First Name:ALECSANDRIA
Middle Name:SHAR
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BOYD COONEY DAM RD
Mailing Address - Street 2:
Mailing Address - City:ROBERTS
Mailing Address - State:MT
Mailing Address - Zip Code:59070-9551
Mailing Address - Country:US
Mailing Address - Phone:307-391-0054
Mailing Address - Fax:
Practice Address - Street 1:7 NORTH WOODARD AVENUE
Practice Address - Street 2:
Practice Address - City:ABSAROKEE
Practice Address - State:MT
Practice Address - Zip Code:59001
Practice Address - Country:US
Practice Address - Phone:307-391-0054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24733225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist