Provider Demographics
NPI:1700671500
Name:ALEXANDER, AJAH YVETTE (QIDP)
Entity type:Individual
Prefix:
First Name:AJAH
Middle Name:YVETTE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:QIDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2683 AVALON WOODS DR
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-7733
Mailing Address - Country:US
Mailing Address - Phone:804-591-8254
Mailing Address - Fax:804-591-8254
Practice Address - Street 1:5340 HOLIDAY TER
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-2196
Practice Address - Country:US
Practice Address - Phone:269-381-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator