Provider Demographics
NPI:1801526728
Name:ALEXANDER, MICHELE S (CPRC)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:S
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:CPRC
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:S
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RECOVERY COACH
Mailing Address - Street 1:10059 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:FENWICK
Mailing Address - State:MI
Mailing Address - Zip Code:48834-9703
Mailing Address - Country:US
Mailing Address - Phone:989-763-9119
Mailing Address - Fax:
Practice Address - Street 1:1115 BALL AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-5904
Practice Address - Country:US
Practice Address - Phone:616-456-6571
Practice Address - Fax:616-774-2044
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator