Provider Demographics
NPI:1558087452
Name:ALEXANDER, LAQUASHA D
Entity Type:Individual
Prefix:
First Name:LAQUASHA
Middle Name:D
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 SOUTHERLY HILLS DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2336
Mailing Address - Country:US
Mailing Address - Phone:937-558-6909
Mailing Address - Fax:
Practice Address - Street 1:236 SOUTHERLY HILLS DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2336
Practice Address - Country:US
Practice Address - Phone:937-558-6909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide