Individual
ALEXIS CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY
Contact information
Practice address
454 BROADWAY, REVERE, MA 02151-3034
(781) 485-8222
Mailing address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11417
MA
103T00000X
Psychologist
31520
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31520
PSYCHOLOGIST
CA
Enumeration date
04/25/2007
Last updated
02/03/2021
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