MEDICARE: ALEXIS HOLTROP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	7101009820	MI

General Provider Information

NPI Number	:	1588519797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS HOLTROP

Provider Business Mailing Address
First Line	:	2450 44TH ST SE STE 201
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49512-9081
Country	:	US
Telephone Number	:	616-528-0870
Fax Number	:	616-591-5684

Provider Business Practice Location Address
First Line	:	2450 44TH ST SE STE 201
Second Line	:
City	:	KENTWOOD
State	:	MI
Zip	:	49512-9081
Country	:	US
Telephone Number	:	616-528-0870
Fax Number	:	616-591-5684

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “ ALEXIS HOLTROP ” Practice Location

Language	Start Address	Practice Location

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