MEDICARE: MRS. LATIFAH ALEXANDER M.S., CCC-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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285046094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LATIFAH ALEXANDER M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	5010 LAKE PARK DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6826
Country	:	US
Telephone Number	:	254-432-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	5010 LAKE PARK DR
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6826
Country	:	US
Telephone Number	:	254-432-1221
Fax Number	:

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

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	10/17/2024

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Directions to “ MRS. LATIFAH ALEXANDER M.S., CCC-SLP” Practice Location

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