MEDICARE: ALEXANDRA LONGO

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	13235	NC

General Provider Information

NPI Number	:	1790212306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA LONGO

Provider Business Mailing Address
First Line	:	251 W CENTER ST
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540-5900
Country	:	US
Telephone Number	:	919-285-2157
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 CENTER STREET
Second Line	:
City	:	HOLLY SPRINGS
State	:	NC
Zip	:	27540
Country	:	US
Telephone Number	:	919-285-2157
Fax Number	:

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

Provider Enumeration Date	:	05/12/2017
Last Update Date	:	01/12/2026

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Directions to “ ALEXANDRA LONGO ” Practice Location

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