Provider Demographics
NPI:1053832576
Name:COYAN, ALYXIS MARIE (LGC)
Entity Type:Individual
Prefix:MS
First Name:ALYXIS
Middle Name:MARIE
Last Name:COYAN
Suffix:
Gender:F
Credentials:LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE # MLC4006
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4760
Mailing Address - Fax:513-636-7297
Practice Address - Street 1:3333 BURNET AVE # MLC4006
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4760
Practice Address - Fax:513-636-7297
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH70.000292TEMP170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS