Most Relevant Information
Provider Data
| NPI Number: | 1003537630 |
| Provider Name: | ALEXSIS CANAAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/12/2022 |
| Last Updated: | 09/12/2022 |
Provider Practice Location
4710 EAGLERIDGE CIR STE 230
PUEBLO
CO
810082176
Practice Location Phone/Fax
| Phone: | 7195828736 |
| Fax: | 7194349767 |
Provider Mailing Location
4710 EAGLERIDGE CIR STE 230
PUEBLO
CO
810082176
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |