Provider Demographics
NPI:1538527361
Name:ALEXANDER, DAVETTA KAYE (LPC-US)
Entity type:Individual
Prefix:
First Name:DAVETTA
Middle Name:KAYE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:LPC-US
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 W OKMULGEE ST
Mailing Address - Street 2:SUITE M
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-6749
Mailing Address - Country:US
Mailing Address - Phone:918-681-4944
Mailing Address - Fax:918-681-4990
Practice Address - Street 1:1601 W OKMULGEE ST
Practice Address - Street 2:SUITE M
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-6749
Practice Address - Country:US
Practice Address - Phone:918-681-4944
Practice Address - Fax:918-681-4990
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional