Provider Demographics
NPI:1033725445
Name:STARNES, ALEXANDRIA WRIDE (MA CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:WRIDE
Last Name:STARNES
Suffix:
Gender:F
Credentials:MA CCC-SLP/L
Other - Prefix:
Other - First Name:LEXIE
Other - Middle Name:
Other - Last Name:STARNES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5829 WOOD VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-9787
Mailing Address - Country:US
Mailing Address - Phone:616-780-1168
Mailing Address - Fax:
Practice Address - Street 1:5829 WOOD VALLEY DR
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-9787
Practice Address - Country:US
Practice Address - Phone:616-780-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101004445235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty