Provider Demographics
NPI:1689402836
Name:RISPALJE, ALEXANDRIA P
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:P
Last Name:RISPALJE
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 1:530 N SILVERBROOK DR UNIT 104
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-2436
Mailing Address - Country:US
Mailing Address - Phone:414-801-9513
Mailing Address - Fax:
Practice Address - Street 1:6140 W EXECUTIVE DR STE B
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-4499
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician