Provider Demographics
NPI:1790512242
Name:ALEXANDRE, OLIVIER
Entity type:Individual
Prefix:MR
First Name:OLIVIER
Middle Name:
Last Name:ALEXANDRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 JOHN STEVEN WAY
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5267
Mailing Address - Country:US
Mailing Address - Phone:317-639-9595
Mailing Address - Fax:
Practice Address - Street 1:2726 JOHN STEVEN WAY
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-5267
Practice Address - Country:US
Practice Address - Phone:317-639-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst