Most Relevant Information
Provider Data
| NPI Number: | 1003529892 |
| Provider Name: | ALEXIS R HENDRA BT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/27/2022 |
| Last Updated: | 12/27/2022 |
Provider Practice Location
6627 ROSE ST
CASS CITY
MI
487261262
Practice Location Phone/Fax
| Phone: | 9898723834 |
| Fax: | 9898394451 |
Provider Mailing Location
6627 ROSE ST
CASS CITY
MI
487261262
Provider Mailing Phone/Fax
| Phone: | 9898723834 |
| Fax: | 9898394451 |