Basic Information
Provider Information
NPI: 1568868891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALEXANDER
FirstName: STORMI
MiddleName: HOPE
NamePrefix: MRS.
NameSuffix:  
Credential: CCC-SLP; BCBA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1321 MURFREESBORO PIKE STE 702
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372172679
CountryCode: US
TelephoneNumber: 6156952277
FaxNumber:  
Practice Location
Address1: 613 STEPHENSON AVE STE 206
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314055841
CountryCode: US
TelephoneNumber: 9123492479
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/13/2014
LastUpdateDate: 06/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSLP004510GAN Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 
103K00000X1-12-1005GAY Behavioral Health & Social Service ProvidersBehavioral Analyst 

No ID Information.


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