Individual
ALEXIS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6255 28TH ST SE, SUITE 3 OFFICE D, GRAND RAPIDS, MI 49546-1565
(616) 284-1527
Mailing address
6255 28TH ST SE, SUITE 3 OFFICE D, GRAND RAPIDS, MI 49546-1565
(616) 284-1527
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6451022613
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/24/2018
Last updated
01/02/2024
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