Provider Demographics
NPI:1578121778
Name:COX, ALEXIS (SLP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 10TH WAY N APT 4112
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1511
Mailing Address - Country:US
Mailing Address - Phone:317-313-6744
Mailing Address - Fax:
Practice Address - Street 1:11901 10TH WAY N APT 4112
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33716-1511
Practice Address - Country:US
Practice Address - Phone:317-313-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty