MEDICARE: ALAINA NICOLE FERNANDEZ MS, 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	SLP.0004366	CO

General Provider Information

NPI Number	:	1508501933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAINA NICOLE FERNANDEZ MS, CCC-SLP

Provider Business Mailing Address
First Line	:	1400 LIBERTY MIDTOWN DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3997
Country	:	US
Telephone Number	:	843-936-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 LIBERTY MIDTOWN DR
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3997
Country	:	US
Telephone Number	:	843-936-2800
Fax Number	:

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

Provider Enumeration Date	:	04/29/2022
Last Update Date	:	09/24/2024

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