MEDICARE: BRIA S ALEXANDER

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	372600000X	Adult Companion

General Provider Information

NPI Number	:	1639930480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIA S ALEXANDER

Provider Business Mailing Address
First Line	:	2124 TENNYSON AVE NE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-7703
Country	:	US
Telephone Number	:	330-998-0006
Fax Number	:

Provider Business Practice Location Address
First Line	:	2124 TENNYSON AVE NE
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646-7703
Country	:	US
Telephone Number	:	330-998-0006
Fax Number	:

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

Provider Enumeration Date	:	01/18/2024
Last Update Date	:	01/18/2024

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Directions to “ BRIA S ALEXANDER ” Practice Location

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