Provider Demographics
NPI:1730668054
Name:WALLENHORST, ALEXANDRA (GC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:WALLENHORST
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:HENSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-688-9551
Mailing Address - Fax:614-293-2200
Practice Address - Street 1:1800 ZOLLINGER RD FL 4
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2800
Practice Address - Country:US
Practice Address - Phone:614-688-9551
Practice Address - Fax:614-293-2200
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS