Provider Demographics
NPI:1770916843
Name:MUCCIOLI, ALEXA JONES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:JONES
Last Name:MUCCIOLI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALEXA
Other - Middle Name:RAE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:32131 INDUSTRIAL RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1836
Mailing Address - Country:US
Mailing Address - Phone:734-762-6600
Mailing Address - Fax:734-762-6601
Practice Address - Street 1:32131 INDUSTRIAL RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1836
Practice Address - Country:US
Practice Address - Phone:734-762-6600
Practice Address - Fax:734-762-6601
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040282183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist