Healthcare Provider Details

I. General information

NPI: 1336055359
Provider Name (Legal Business Name): ALEXANDRIA BACARELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 WASHTENAW AVE STE 4
ANN ARBOR MI
48104-4525
US

IV. Provider business mailing address

2350 WASHTENAW AVE STE 4
ANN ARBOR MI
48104-4525
US

V. Phone/Fax

Practice location:
  • Phone: 888-764-3578
  • Fax: 734-661-0984
Mailing address:
  • Phone: 888-764-3578
  • Fax: 734-661-0984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: