Healthcare Provider Details

I. General information

NPI: 1982955258
Provider Name (Legal Business Name): ALICIA BROOKE ALGER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 03/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S CRAPO ST
MOUNT PLEASANT MI
48858-2941
US

IV. Provider business mailing address

375 APPLE TREE DR
IONIA MI
48846-7506
US

V. Phone/Fax

Practice location:
  • Phone: 989-775-5938
  • Fax: 989-775-7701
Mailing address:
  • Phone: 616-527-1790
  • Fax: 616-527-0538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: