Provider Demographics
NPI:1053552521
Name:ALEXANDER, ROBERT JAMES (MA BCBA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 E 56TH ST
Mailing Address - Street 2:311
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1952
Mailing Address - Country:US
Mailing Address - Phone:248-880-8614
Mailing Address - Fax:
Practice Address - Street 1:1642 E 56TH ST
Practice Address - Street 2:311
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1952
Practice Address - Country:US
Practice Address - Phone:248-880-8614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst