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NPI Code Detail

MEDICARE: ALEXIS MIDDLETON M.S. CF-SLP

MEDICARE:   ALEXIS  MIDDLETON  M.S. CF-SLP
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
1235Z00000XSpeech-Language Pathologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245904986
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS MIDDLETON M.S. CF-SLP
Provider Business Mailing Address
First Line : 304 LAUREL DR
Second Line :
City : SOUTH JACKSONVILLE
State : IL
Zip : 62650-3407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 304 LAUREL DR
Second Line :
City : SOUTH JACKSONVILLE
State : IL
Zip : 62650-3407
Country : US
Telephone Number : 217-473-6569
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2021
Last Update Date : 08/05/2021

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Directions to “ ALEXIS MIDDLETON M.S. CF-SLP” Practice Location

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