Healthcare Provider Details

I. General information

NPI: 1811323215
Provider Name (Legal Business Name): TARY ANN ALEXANDER MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14930 LAPLAISANCE RD STE 118
MONROE MI
48161-3878
US

IV. Provider business mailing address

4841 MONROE ST
TOLEDO OH
43623-4385
US

V. Phone/Fax

Practice location:
  • Phone: 734-888-6461
  • Fax: 734-275-0985
Mailing address:
  • Phone: 419-241-6219
  • Fax: 419-241-5912

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: