Individual
ALEXANDRIA MINIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1535 PROVIDENT DR, WARSAW, IN 46580-3294
(574) 387-4313
(574) 204-2868
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
(574) 387-4313
(574) 204-2868
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-369468
IN
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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