MEDICARE: ALEXA STEWART COLVIN

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	202932	AR

General Provider Information

NPI Number	:	1750244786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXA STEWART COLVIN

Provider Business Mailing Address
First Line	:	1898 S DORAL DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-7794
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1898 S DORAL DR
Second Line	:
City	:	FAYETTEVILLE
State	:	AR
Zip	:	72701-7794
Country	:	US
Telephone Number	:	479-957-4008
Fax Number	:

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

Provider Enumeration Date	:	12/05/2025
Last Update Date	:	12/05/2025

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Directions to “ ALEXA STEWART COLVIN ” Practice Location

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