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General NPI Number Information
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NPI Number | 1720460728
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Entity Type | Individual
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Provider Name | ALEXANDRA HENDERSON MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/25/2015
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 6851 S HOLLY CIR STE 290
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City | CENTENNIAL
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State | CO
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Zip | 80112-1076
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Country | US
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Telephone | 205-428-7377
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Fax |
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Provider Business Mailing Address
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Address Line | 3090 N ACADEMY BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-5310
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Country | US
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Telephone | 719-574-8300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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