Individual
MISS ALEXA STATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
678 TROY SCHENECTADY RD STE 201, LATHAM, NY 12110-2503
(315) 853-6090
(315) 853-3190
Mailing address
5 JODIRO LN APT 101, ALBANY, NY 12205-2551
(315) 853-6090
(315) 853-3190
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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