Provider Demographics
NPI:1881943611
Name:ALEXANDER, KIA WALNIKWA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIA
Middle Name:WALNIKWA
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:KIA
Other - Middle Name:WALNIKWA
Other - Last Name:LEMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:529 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-6101
Mailing Address - Country:US
Mailing Address - Phone:214-815-8998
Mailing Address - Fax:
Practice Address - Street 1:529 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-6101
Practice Address - Country:US
Practice Address - Phone:214-815-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24910235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist