Provider Demographics
NPI:1982383824
Name:FLETES, ALEJANDRA
Entity Type:Individual
Prefix:MISS
First Name:ALEJANDRA
Middle Name:
Last Name:FLETES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:ALEJANDRA
Other - Middle Name:
Other - Last Name:GULLION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:900 MOUNTAIN CREEK RD APT L156
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:720 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-1925
Practice Address - Country:US
Practice Address - Phone:423-266-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer