Provider Demographics
NPI:1134808090
Name:O'LEARY, ALEXA RAE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAE
Last Name:O'LEARY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:RAE
Other - Last Name:BARONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 LACKEY ROAD
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590
Mailing Address - Country:US
Mailing Address - Phone:508-873-9944
Mailing Address - Fax:
Practice Address - Street 1:55 LACKEY ROAD
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:MA
Practice Address - Zip Code:01590
Practice Address - Country:US
Practice Address - Phone:508-873-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9825235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist