Individual
ALEXIS THREAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2076 S INDEPENDENCE BLVD STE 1B, VIRGINIA BEACH, VA 23453-4773
(757) 622-7272
Mailing address
3864 BANYAN GROVE LN APT 206, VIRGINIA BEACH, VA 23462-7491
(757) 609-5416
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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