Individual
ALEXIS GRACE LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
320 MIDLAND PKWY STE C, SUMMERVILLE, SC 29485-7195
(574) 551-1548
Mailing address
320 MIDLAND PKWY STE C, SUMMERVILLE, SC 29485-7195
(574) 551-1548
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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