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General NPI Number Information
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NPI Number | 1801199740
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Entity Type | Individual
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Provider Name | ALEXIS J PAGE M.S. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2010
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 8310 RIVERS AVE STE D
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9268
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Country | US
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Telephone | 843-588-5677
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Fax | 855-632-2877
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Provider Business Mailing Address
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Address Line | 379 AZORE WAY
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2437
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Country | US
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Telephone | 845-926-8311
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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 | 020361-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7845
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License Number State | SC
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