Individual
CAROLINE RUTH ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2750 E BELTLINE AVE NE LOWR LEVEL, GRAND RAPIDS, MI 49525-8614
(616) 447-5880
(616) 391-6238
Mailing address
2750 E BELTLINE AVE NE LOWR LEVEL, GRAND RAPIDS, MI 49525-8614
(616) 447-5880
(616) 391-6238
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
14273
NC
235Z00000X
Speech-Language Pathologist
Primary
7101007441
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NONE AVAILABLE; MEDICAID APPLICATION IN PROCESS
—
Enumeration date
08/18/2020
Last updated
03/14/2023
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