Individual
MICHELLE M ALEXANDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LW, PHD, BCBA, LBA
Contact information
Practice address
13765 VINTAGE DR SW, PORT ORCHARD, WA 98367-7391
(253) 970-2414
Mailing address
PO BOX 4188, BREMERTON, WA 98312-0188
(360) 633-2417
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA60813130
WA
1041C0700X
Clinical Social Worker
ISW01732
RI
1041C0700X
Clinical Social Worker
LW60485498
WA
Other
Enumeration date
05/03/2006
Last updated
09/25/2020
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