MEDICARE: ALENA MENDOZA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1023942778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALENA MENDOZA

Provider Business Mailing Address
First Line	:	4305 CHALICE DR
Second Line	:
City	:	SOUTHAVEN
State	:	MS
Zip	:	38672-7112
Country	:	US
Telephone Number	:	210-585-0710
Fax Number	:

Provider Business Practice Location Address
First Line	:	2018 EXETER RD
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38138-3945
Country	:	US
Telephone Number	:	210-585-0710
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ ALENA MENDOZA ” Practice Location

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