Basic Information
Provider Information
NPI: 1932820644
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEOPLES
FirstName: ALEXANDRIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12665 CLEVELAND AVE NW
Address2:  
City: UNIONTOWN
State: OH
PostalCode: 446859126
CountryCode: US
TelephoneNumber: 3305100677
FaxNumber:  
Practice Location
Address1: 919 2ND ST NE
Address2:  
City: CANTON
State: OH
PostalCode: 447041132
CountryCode: US
TelephoneNumber: 3304547917
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/09/2022
LastUpdateDate: 09/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  Y Other Service ProvidersCase Manager/Care Coordinator 

No ID Information.


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