Provider Demographics
NPI:1396546362
Name:ADAMS, ALEXIS JORDYN
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JORDYN
Last Name:ADAMS
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 1:11205 BRIDGE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5403
Mailing Address - Country:US
Mailing Address - Phone:407-259-1463
Mailing Address - Fax:
Practice Address - Street 1:1633 E VINE ST STE 213
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3705
Practice Address - Country:US
Practice Address - Phone:407-588-7776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI76542355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant