Patricia Anne Alexander, MA CCC

Individual provider Active NPI Speech-Language Pathologist · Broken Arrow, OK

NPI 1750464871 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1750464871
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
366 (OK)
Practice address
708 W Freeport
Broken Arrow, OK 74012
Phone
(918) 455-3859
Fax
(918) 455-3860
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
366OKMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Educational Therapy Center Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 366 OK Yes

Addresses

Primary practice location

708 W Freeport
Broken Arrow, OK 74012

Mailing address

708 W Freeport
Broken Arrow, OK 74012
Phone (918) 455-3859

Other providers in Broken Arrow, OK

All providers in Broken Arrow, OK · Speech-Language Pathologist in Oklahoma

Sources for this page

Verify at the official NPI Registry.