Provider Demographics
NPI:1427343961
Name:STREIN, ALICIA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:MARIE
Last Name:STREIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 AVERY
Mailing Address - Street 2:APT. 302
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8009
Mailing Address - Country:US
Mailing Address - Phone:704-796-7491
Mailing Address - Fax:
Practice Address - Street 1:11030 RAVEN RIDGE RD STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8512
Practice Address - Country:US
Practice Address - Phone:919-844-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist