Provider Demographics
NPI:1164104063
Name:WRIGHT, ALEXIS PAIGE
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:PAIGE
Last Name:WRIGHT
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 1:214 E GEIGER ST
Mailing Address - Street 2:
Mailing Address - City:MORGANFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42437-1710
Mailing Address - Country:US
Mailing Address - Phone:270-952-4971
Mailing Address - Fax:
Practice Address - Street 1:2003 STAPP DR UNIT C
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-1601
Practice Address - Country:US
Practice Address - Phone:270-952-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist