Individual
ALEXANDRA KATHLEEN WELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3361 36TH ST SE, GRAND RAPIDS, MI 49512-2809
(616) 826-4991
Mailing address
854 JOSLIN ST SE, GRAND RAPIDS, MI 49507-3308
(616) 280-1174
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
7401000254
MI
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/02/2016
Last updated
08/25/2021
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