Individual
MS. ALEXANDRIA ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
14405 FORDLINE ST, SOUTHGATE, MI 48195-2569
(131) 331-8392
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6362009374
MI
Other
Enumeration date
03/01/2023
Last updated
03/01/2023
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