Provider Demographics
NPI:1992442594
Name:DEGUZMAN, ALEXIS MARIE
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MARIE
Last Name:DEGUZMAN
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 1:101 E ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:SOUTH MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27976-9447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 E ROBIN CT
Practice Address - Street 2:
Practice Address - City:SOUTH MILLS
Practice Address - State:NC
Practice Address - Zip Code:27976-9447
Practice Address - Country:US
Practice Address - Phone:252-333-5996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer