Provider Demographics
NPI:1376927160
Name:PRICE, ALEXANDRA BETLEY
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BETLEY
Last Name:PRICE
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 1:2278 EDGEVALE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1216
Mailing Address - Country:US
Mailing Address - Phone:614-746-1676
Mailing Address - Fax:
Practice Address - Street 1:2278 EDGEVALE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-1216
Practice Address - Country:US
Practice Address - Phone:614-746-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12422235Z00000X
NC10035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist