Provider Demographics
NPI:1902613664
Name:HARRER, ALEXANDRA LYNN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LYNN
Last Name:HARRER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 RACE ST APT 217
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-2561
Mailing Address - Country:US
Mailing Address - Phone:484-364-9175
Mailing Address - Fax:
Practice Address - Street 1:401 RACE ST APT 217
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-2561
Practice Address - Country:US
Practice Address - Phone:484-364-9175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL018101235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty