Provider Demographics
NPI:1114774304
Name:WATKINS, ALEXIS R
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:R
Last Name:WATKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45210 JEWETT HOPEDALE RD
Mailing Address - Street 2:
Mailing Address - City:JEWETT
Mailing Address - State:OH
Mailing Address - Zip Code:43986-9531
Mailing Address - Country:US
Mailing Address - Phone:740-946-1093
Mailing Address - Fax:
Practice Address - Street 1:250 CADIZ RD
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3928
Practice Address - Country:US
Practice Address - Phone:740-264-5245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-04
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist