Provider Demographics
NPI:1699341768
Name:DELOZIER, ALEXANDRIA JADE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:JADE
Last Name:DELOZIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 FLINTLOCK LN
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:OK
Mailing Address - Zip Code:74740-4207
Mailing Address - Country:US
Mailing Address - Phone:903-556-2077
Mailing Address - Fax:
Practice Address - Street 1:1303 S LYNN LN
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-6845
Practice Address - Country:US
Practice Address - Phone:580-286-7025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-31
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS601068103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical