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NPI Code Detail

MEDICARE: SHAVON R ALEXANDER

MEDICARE: SHAVON R ALEXANDER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1952993297
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAVON R ALEXANDER
Provider Business Mailing Address
First Line : 36875 MCKINNEY AVE APT 301
Second Line :
City : WESTLAND
State : MI
Zip : 48185-1373
Country : US
Telephone Number : 313-844-1557
Fax Number :
Provider Business Practice Location Address
First Line : 27780 NOVI RD STE 244
Second Line :
City : NOVI
State : MI
Zip : 48377-3427
Country : US
Telephone Number : 313-437-7762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2021
Last Update Date : 03/10/2023

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Directions to “ SHAVON R ALEXANDER ” Practice Location

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