Provider Demographics
NPI:1689566770
Name:COLBERG, ALEXANDRA (MGCS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:COLBERG
Suffix:
Gender:F
Credentials:MGCS
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:COLBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MGCS
Mailing Address - Street 1:9500 EUCLID AVE # C15
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-6935
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # C15
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-6935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000952TEMP170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS