Provider Demographics
NPI:1750432084
Name:ROBERTS, ALECIA B
Entity type:Individual
Prefix:MRS
First Name:ALECIA
Middle Name:B
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 DAVIDSON DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-4351
Mailing Address - Country:US
Mailing Address - Phone:704-786-9297
Mailing Address - Fax:704-793-1388
Practice Address - Street 1:21 SAND DOLLAR CT
Practice Address - Street 2:
Practice Address - City:CAROLINA SHORES
Practice Address - State:NC
Practice Address - Zip Code:28467-2500
Practice Address - Country:US
Practice Address - Phone:843-360-0822
Practice Address - Fax:910-663-4050
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1039237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1039OtherLICENSE NUMBER