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General NPI Number Information
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NPI Number | 1619791373
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Entity Type | Individual
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Provider Name | ALEXANDRIA LEIGH CONGER LLPC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 28175 HAGGERTY RD
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City | NOVI
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State | MI
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Zip | 48377-2903
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Country | US
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Telephone | 630-313-2575
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Fax |
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Provider Business Mailing Address
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Address Line | 4260 S HARRELL RD
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City | BLOOMINGTON
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State | IN
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Zip | 47401-9092
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Country | US
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Telephone | 812-320-9002
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6451022477
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License Number State | MI
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