Provider Demographics
NPI:1003129560
Name:RAND, ALEXIS CHRISTIAN (MS, BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:CHRISTIAN
Last Name:RAND
Suffix:
Gender:
Credentials:MS, BCBA, LBA
Other - Prefix:MS
Other - First Name:ALEXIS
Other - Middle Name:ANN
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:4677 DUDLEY LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-3304
Mailing Address - Country:US
Mailing Address - Phone:202-904-6986
Mailing Address - Fax:
Practice Address - Street 1:4677 DUDLEY LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3304
Practice Address - Country:US
Practice Address - Phone:202-904-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-26
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN292103K00000X
TN1-13-14065103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1532316Medicaid