Provider Demographics
NPI:1922522713
Name:YOWELL, ALEXANDRA BLAIR (AUD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BLAIR
Last Name:YOWELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:BLAIR
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:808 TRITON COURT SUITE 100
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4520
Mailing Address - Country:US
Mailing Address - Phone:757-874-4665
Mailing Address - Fax:757-874-1286
Practice Address - Street 1:1708 FALL HILL AVE STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3511
Practice Address - Country:US
Practice Address - Phone:540-371-1263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001668231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist