Provider Demographics
NPI:1740972835
Name:MILLERING, ALLEXIUS
Entity type:Individual
Prefix:
First Name:ALLEXIUS
Middle Name:
Last Name:MILLERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEXI
Other - Middle Name:
Other - Last Name:MILLERING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4829 E BELTLINE AVE NE STE 310
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9350
Mailing Address - Country:US
Mailing Address - Phone:616-279-6414
Mailing Address - Fax:616-591-3393
Practice Address - Street 1:4829 E BELTLINE AVE NE STE 310
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9350
Practice Address - Country:US
Practice Address - Phone:616-279-6414
Practice Address - Fax:616-591-3393
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician