Provider Demographics
NPI:1710582978
Name:DYESS, ALEXIS D (MA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:D
Last Name:DYESS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13645 E COLONIAL DR APT C366
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4931
Mailing Address - Country:US
Mailing Address - Phone:772-323-8372
Mailing Address - Fax:
Practice Address - Street 1:305 E OAK ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4352
Practice Address - Country:US
Practice Address - Phone:407-880-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist