Provider Demographics
NPI:1316637820
Name:MEDD, ALEXA PALMER (MS)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:PALMER
Last Name:MEDD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16894 KETCH CT
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-5012
Mailing Address - Country:US
Mailing Address - Phone:302-519-1117
Mailing Address - Fax:
Practice Address - Street 1:17344 SWEETBRIAR RD
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4021
Practice Address - Country:US
Practice Address - Phone:302-645-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE01-0012214235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist