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Individual

ALEXA MELIA LAWRENCE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
201 W LEE ST, ENTERPRISE, AL 36330-2424
(334) 618-3302
Mailing address
201 W LEE ST, ENTERPRISE, AL 36330-2424
(334) 618-3302

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22251541
22251541
AL
Enumeration date
01/11/2023
Last updated
01/11/2023
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