Provider Demographics
NPI:1083097430
Name:SCHUSTER, ALEXA MEGAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ALEXA
Middle Name:MEGAN
Last Name:SCHUSTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15028 LAKE EMERALD BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1700
Mailing Address - Country:US
Mailing Address - Phone:813-679-6242
Mailing Address - Fax:
Practice Address - Street 1:15028 LAKE EMERALD BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-1700
Practice Address - Country:US
Practice Address - Phone:813-679-6242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13347235Z00000X
DCSLP000884235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist