Provider Demographics
NPI:1790332054
Name:YOUNKERS, ALEXIS (MS CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:YOUNKERS
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15550 CRIMSON TOPAZ
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4051
Mailing Address - Country:US
Mailing Address - Phone:302-159-5415
Mailing Address - Fax:
Practice Address - Street 1:8449 F M 471 S
Practice Address - Street 2:
Practice Address - City:CASTROVILLE
Practice Address - State:TX
Practice Address - Zip Code:78009
Practice Address - Country:US
Practice Address - Phone:830-931-2243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-11-22
Deactivation Date:2022-10-07
Deactivation Code:
Reactivation Date:2022-11-08
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120371OtherTEXAS DEPARTMENT OF LICENSING AND REGULATION