MEDICARE: ALEXANDRA ROY CF-SLP

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	033	OK

General Provider Information

NPI Number	:	1063902252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA ROY CF-SLP

Provider Business Mailing Address
First Line	:	7400 ARBOR VALLEY DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1853
Country	:	US
Telephone Number	:	405-760-3663
Fax Number	:

Provider Business Practice Location Address
First Line	:	9085 HARMONY DR
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73130-6217
Country	:	US
Telephone Number	:	405-397-3553
Fax Number	:

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

Provider Enumeration Date	:	05/14/2018
Last Update Date	:	05/14/2018

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