Provider Demographics
NPI:1922561455
Name:MCCOWIN, ALEXIS MCKENZIE (MA-CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MCKENZIE
Last Name:MCCOWIN
Suffix:
Gender:F
Credentials:MA-CF-SLP
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:MCKENZIE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 YOUNGSTOWN WARREN RD STE A
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-4626
Mailing Address - Country:US
Mailing Address - Phone:330-505-1606
Mailing Address - Fax:330-423-4555
Practice Address - Street 1:950 YOUNGSTOWN WARREN RD STE A
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4626
Practice Address - Country:US
Practice Address - Phone:330-505-1606
Practice Address - Fax:330-423-4555
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2018920-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist