Individual
ALEXIS KOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 MEADOWLANDS DR STE 1&2, WHITE BEAR LAKE, MN 55127-2339
(612) 315-1976
Mailing address
2333 13TH AVE E, NORTH SAINT PAUL, MN 55109-2423
(651) 353-1628
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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