Provider Demographics
NPI:1396560066
Name:WILLIAMS, ALEXIS KATHERINE (RBT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KATHERINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 GREENWOOD BLVD APT 9
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63143-4240
Mailing Address - Country:US
Mailing Address - Phone:618-610-8998
Mailing Address - Fax:
Practice Address - Street 1:11780 BORMAN DR STE 400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4135
Practice Address - Country:US
Practice Address - Phone:618-610-8998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician