Healthcare Provider Details

I. General information

NPI: 1164332011
Provider Name (Legal Business Name): ALEXANDRA MARIE BILLIRIS CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 19TH ST NW
ROANOKE VA
24017-3420
US

IV. Provider business mailing address

1616 19TH ST NW
ROANOKE VA
24017-3420
US

V. Phone/Fax

Practice location:
  • Phone: 540-853-2751
  • Fax:
Mailing address:
  • Phone: 540-853-2751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2204001790
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: