Individual
ALEXANDRA ROSE MULARONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5366 EASTERN AVE SE, KENTWOOD, MI 49508-6018
(616) 608-3665
Mailing address
5366 EASTERN AVE SE, KENTWOOD, MI 49508-6018
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
462053890
AUTISM CENTERS OF MICHIGAN
MI
Enumeration date
05/14/2018
Last updated
05/14/2018
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