Provider Demographics
NPI:1740004555
Name:ALEXANDER, SHAUNMETRIA CHANTAY (RBT)
Entity type:Individual
Prefix:MS
First Name:SHAUNMETRIA
Middle Name:CHANTAY
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3606 HEATHERBROOKE PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-8012
Mailing Address - Country:US
Mailing Address - Phone:205-373-9162
Mailing Address - Fax:
Practice Address - Street 1:215 NARROWS PKWY STE E
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-8623
Practice Address - Country:US
Practice Address - Phone:205-362-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24-363231106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician