Provider Demographics
NPI:1285369637
Name:URBINA, ALEXIS ADRIANA
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ADRIANA
Last Name:URBINA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:551 WOOD AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-2195
Mailing Address - Country:US
Mailing Address - Phone:401-636-6525
Mailing Address - Fax:
Practice Address - Street 1:551 WOOD AVE APT 3F
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-2195
Practice Address - Country:US
Practice Address - Phone:401-636-6525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician