Provider Demographics
NPI:1699599357
Name:GIRARD, ALEXANDRA KAY
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:KAY
Last Name:GIRARD
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 1:4447 OCEAN FARM DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9326
Mailing Address - Country:US
Mailing Address - Phone:757-717-6047
Mailing Address - Fax:
Practice Address - Street 1:4447 OCEAN FARM DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-9326
Practice Address - Country:US
Practice Address - Phone:757-717-6047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician