Provider Demographics
NPI:1275371676
Name:SZACHACZ, ALEXA (CF-SLP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:SZACHACZ
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7773
Mailing Address - Country:US
Mailing Address - Phone:321-501-6793
Mailing Address - Fax:
Practice Address - Street 1:3490 THRIVE DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5082
Practice Address - Country:US
Practice Address - Phone:329-354-7081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ12055235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist