Provider Demographics
NPI:1508073388
Name:HEFLIN, ALEXIS ANNE (MS CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:ANNE
Last Name:HEFLIN
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 1:1017 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2592
Mailing Address - Country:US
Mailing Address - Phone:304-623-5198
Mailing Address - Fax:304-623-0221
Practice Address - Street 1:171 LIBERTY AVE
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-4118
Practice Address - Country:US
Practice Address - Phone:304-624-5009
Practice Address - Fax:304-623-0221
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist