MEDICARE: ALEXA MCKEE

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	106S00000X	Behavior Technician
2	235Z00000X	Speech-Language Pathologist	TL-3873	NJ

General Provider Information

NPI Number	:	1093279390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA MCKEE

Provider Business Mailing Address
First Line	:	1500 MEETING HOUSE RD BLDG 21
Second Line	:
City	:	SEA GIRT
State	:	NJ
Zip	:	08750-2220
Country	:	US
Telephone Number	:	848-251-5355
Fax Number	:

Provider Business Practice Location Address
First Line	:	950 HOOPER AVE STE 2
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-8372
Country	:	US
Telephone Number	:	848-251-5355
Fax Number	:	848-224-4462

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

Provider Enumeration Date	:	01/31/2019
Last Update Date	:	11/16/2022

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Directions to “ ALEXA MCKEE ” Practice Location

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