Provider Demographics
NPI:1578160602
Name:SCOGGIN, ALEXIS (SLPA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SCOGGIN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 WARWICK CIR W
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-3139
Mailing Address - Country:US
Mailing Address - Phone:903-220-3755
Mailing Address - Fax:
Practice Address - Street 1:1908 WARWICK CIR W
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3139
Practice Address - Country:US
Practice Address - Phone:903-220-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX407972355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant