MEDICARE: ALEXANDRA BLOCHER 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	TSLP10756	AZ
2	235Z00000X	Speech-Language Pathologist	15451	NC

General Provider Information

NPI Number	:	1437677879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA BLOCHER M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	134 INFIELD CT
Second Line	:
City	:	MOORESVILLE
State	:	NC
Zip	:	28117-8026
Country	:	US
Telephone Number	:	704-799-6824
Fax Number	:	704-799-6825

Provider Business Practice Location Address
First Line	:	16415 NORTHCROSS DR STE F
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5001
Country	:	US
Telephone Number	:	704-799-6824
Fax Number	:	704-799-6825

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

Provider Enumeration Date	:	09/06/2017
Last Update Date	:	07/15/2022

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Directions to “ ALEXANDRA BLOCHER M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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