Individual
ALEXANDRIA BANFILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8413 COTTONWOOD DR, JENISON, MI 49428-8327
(574) 387-4313
Mailing address
8413 COTTONWOOD DR, JENISON, MI 49428-8327
(574) 387-4313
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1-23-68526
MI
Other
Enumeration date
02/22/2024
Last updated
02/22/2024
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