MEDICARE: ALEXINA CHRISTINE WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	308441	KY

General Provider Information

NPI Number	:	1235064999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXINA CHRISTINE WILSON

Provider Business Mailing Address
First Line	:	1512 LONGFIELD AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40215-1930
Country	:	US
Telephone Number	:	502-438-0739
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 LONGFIELD AVE
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40215-1930
Country	:	US
Telephone Number	:	502-438-0739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/16/2026

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Directions to “ ALEXINA CHRISTINE WILSON ” Practice Location

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