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General NPI Number Information
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NPI Number | 1326902339
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Entity Type | Individual
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Provider Name | ALEXIA SEPULVEDA
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Gender | Female
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Dates
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Enumeration Date | 12/13/2025
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Last Update Date | 12/13/2025
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Provider Practice Location Address
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Address Line | 860 HAINES
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City | LIBERTY
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State | MO
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Zip | 64068-1006
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Country | US
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Telephone | 816-265-1170
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Fax |
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Provider Business Mailing Address
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Address Line | 120 SW GARDEN ST
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City | GRAIN VALLEY
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State | MO
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Zip | 64029-9548
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Country | US
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Telephone | 816-265-1170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1443198
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License Number State | MO
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