Healthcare Provider Details

I. General information

NPI: 1306584313
Provider Name (Legal Business Name): ALEXA DARRACQ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 W PRINCE RD
TUCSON AZ
85705-3024
US

IV. Provider business mailing address

2600 W IRONWOOD HILL DR APT 17184
TUCSON AZ
85745-4004
US

V. Phone/Fax

Practice location:
  • Phone: 520-696-8836
  • Fax:
Mailing address:
  • Phone: 870-421-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: