Provider Demographics
NPI:1649065558
Name:FAULKNOR, ALEXIS (MS)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:FAULKNOR
Suffix:
Gender:
Credentials:MS
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:SILVERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1275 SHILOH RD NW STE 2330
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7183
Mailing Address - Country:US
Mailing Address - Phone:478-561-1444
Mailing Address - Fax:706-739-4703
Practice Address - Street 1:1275 SHILOH RD NW STE 2330
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7183
Practice Address - Country:US
Practice Address - Phone:478-561-1444
Practice Address - Fax:706-739-4703
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP013293235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist