Most Relevant Information
Provider Data
| NPI Number: | 1003576844 |
| Provider Name: | ALEXIS WHEELER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/21/2021 |
| Last Updated: | 12/21/2021 |
Provider Practice Location
1070 W HOUGHTON LAKE DR
PRUDENVILLE
MI
486519613
Practice Location Phone/Fax
| Phone: | 9893665341 |
| Fax: |
Provider Mailing Location
PO BOX 248
HOUGHTON LAKE
MI
486290248
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |