Provider Demographics
NPI:1982472189
Name:PETERS, ALESSANDRA
Entity Type:Individual
Prefix:MISS
First Name:ALESSANDRA
Middle Name:
Last Name:PETERS
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 1:17 MICHELLE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ST. CATHARINES
Mailing Address - State:ON
Mailing Address - Zip Code:L2S 3G7
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 MICHELLE DRIVE
Practice Address - Street 2:
Practice Address - City:ST. CATHARINES
Practice Address - State:ON
Practice Address - Zip Code:L2S 3G7
Practice Address - Country:CA
Practice Address - Phone:289-214-8657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist