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General NPI Number Information
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NPI Number | 1831641984
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Entity Type | Individual
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Provider Name | ALEXANDRA TESIA THEMELIS M.S. CCC-SUP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 10752 N. 89TH PLACE SUITE C128
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City | SCOTTSDALE
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State | AZ
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Zip | 85260
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Country | US
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Telephone | 480-247-9190
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Fax | 480-247-9718
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Provider Business Mailing Address
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Address Line | 18220 N 68TH ST APT 208
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City | PHOENIX
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State | AZ
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Zip | 85054-9208
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Country | US
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Telephone | 425-275-6169
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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 | SP60602995
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License Number State | WA
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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 | SLP12486
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License Number State | AZ
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