Most Relevant Information
Provider Data
| NPI Number: | 1003671074 |
| Provider Name: | ALEXANDRA GACKLE LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | A2109013 |
Most Important Dates
| Enumeration Date: | 02/19/2024 |
| Last Updated: | 04/11/2024 |
Provider Practice Location
28 S COLLEGE AVE STE 4A
FAYETTEVILLE
AR
727015344
Practice Location Phone/Fax
| Phone: | 9136698795 |
| Fax: |
Provider Mailing Location
28 S COLLEGE AVE STE 4A
FAYETTEVILLE
AR
727015344
Provider Mailing Phone/Fax
| Phone: | 9136698795 |
| Fax: |