Healthcare Provider Details

I. General information

NPI: 1003610460
Provider Name (Legal Business Name): ALEXANDRA TAYLOR SALERNO CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N HAYNE ST UNIT 100
MONROE NC
28112-4883
US

IV. Provider business mailing address

PO BOX 749
BELMONT NC
28012-0749
US

V. Phone/Fax

Practice location:
  • Phone: 980-313-4901
  • Fax: 980-315-4337
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30003883
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: