Provider Demographics
NPI:1477745230
Name:WILCOX, ALEXIA NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:NICOLE
Last Name:WILCOX
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 1:520 S 7TH ST
Mailing Address - Street 2:PHYSICAL MEDICINE DEPARTMENT
Mailing Address - City:VINCENNES
Mailing Address - State:IN
Mailing Address - Zip Code:47591-1038
Mailing Address - Country:US
Mailing Address - Phone:812-885-3211
Mailing Address - Fax:812-885-3217
Practice Address - Street 1:520 S 7TH ST
Practice Address - Street 2:PHYSICAL MEDICINE DEPARTMENT
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-1038
Practice Address - Country:US
Practice Address - Phone:812-885-3211
Practice Address - Fax:812-885-3217
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22004739A235Z00000X
IL146.009598235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist