Provider Demographics
NPI:1932900750
Name:COLES, ALEXANDRA EVE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:EVE
Last Name:COLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:EVE
Other - Last Name:CELLURALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:PA
Mailing Address - Zip Code:15419-1118
Mailing Address - Country:US
Mailing Address - Phone:724-562-2522
Mailing Address - Fax:
Practice Address - Street 1:412 4TH ST
Practice Address - Street 2:
Practice Address - City:CALIFORNIA
Practice Address - State:PA
Practice Address - Zip Code:15419-1118
Practice Address - Country:US
Practice Address - Phone:724-562-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist