Healthcare Provider Details

I. General information

NPI: 1689349805
Provider Name (Legal Business Name): ALEXIS MARNIQUE LENOIR OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 RIDGEWOOD DR
MIDLAND MI
48642-6425
US

IV. Provider business mailing address

5802 OLIVE TREE DR APT G7
SAGINAW MI
48603-3562
US

V. Phone/Fax

Practice location:
  • Phone: 989-835-6333
  • Fax: 989-835-4920
Mailing address:
  • Phone: 989-890-5121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5201014788
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: