Healthcare Provider Details

I. General information

NPI: 1205755881
Provider Name (Legal Business Name): ALEXIS FOWLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 INWOOD AVE
WHEATON MD
20902-3638
US

IV. Provider business mailing address

1715 P ST NW
WASHINGTON DC
20036-1332
US

V. Phone/Fax

Practice location:
  • Phone: 404-276-7775
  • Fax:
Mailing address:
  • Phone: 404-276-7775
  • 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: