Provider Demographics
NPI:1619534195
Name:ALEXANDER, DIONDRA KELLI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:DIONDRA
Middle Name:KELLI
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15727 STILLWATER AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-2464
Mailing Address - Country:US
Mailing Address - Phone:225-715-8569
Mailing Address - Fax:
Practice Address - Street 1:628 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70802-5342
Practice Address - Country:US
Practice Address - Phone:225-342-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist