Provider Demographics
NPI:1053717827
Name:CARR, ALEXANDRA (RBT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-4165
Mailing Address - Country:US
Mailing Address - Phone:316-308-4184
Mailing Address - Fax:316-634-8891
Practice Address - Street 1:1650 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-4165
Practice Address - Country:US
Practice Address - Phone:316-308-4184
Practice Address - Fax:316-634-8891
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician