Provider Demographics
NPI:1366955312
Name:BARTON, ALEXANDRA JEAN-NICOLE (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:JEAN-NICOLE
Last Name:BARTON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 JOYFUL WAY
Mailing Address - Street 2:
Mailing Address - City:WHITE STONE
Mailing Address - State:VA
Mailing Address - Zip Code:22578-2536
Mailing Address - Country:US
Mailing Address - Phone:804-436-7710
Mailing Address - Fax:
Practice Address - Street 1:36 PRIMARY SCHOOL CIR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:VA
Practice Address - Zip Code:22503-2336
Practice Address - Country:US
Practice Address - Phone:804-462-5100
Practice Address - Fax:804-462-5100
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA14281750235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist