Provider Demographics
NPI:1225736382
Name:GROVEMAN, ALEXANDRA (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GROVEMAN
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 ABBOTTSWELL DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7705
Mailing Address - Country:US
Mailing Address - Phone:404-863-8190
Mailing Address - Fax:
Practice Address - Street 1:500 SPRING ST SE STE 101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3773
Practice Address - Country:US
Practice Address - Phone:770-615-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP012481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist