Provider Demographics
NPI:1417655234
Name:NOLAN, ALEXANDRA DIANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:DIANNE
Last Name:NOLAN
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 1:88 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-4338
Mailing Address - Country:US
Mailing Address - Phone:978-852-7100
Mailing Address - Fax:
Practice Address - Street 1:87 ELM ST
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1638
Practice Address - Country:US
Practice Address - Phone:401-443-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP96030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist