Provider Demographics
NPI:1902929284
Name:ALEXANDER, RAYMOND NMN II (PHD)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:NMN
Last Name:ALEXANDER
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 MCGILL PARK AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1274
Mailing Address - Country:US
Mailing Address - Phone:404-664-8838
Mailing Address - Fax:
Practice Address - Street 1:821 MCGILL PARK AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1274
Practice Address - Country:US
Practice Address - Phone:404-664-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA219101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)