Provider Demographics
NPI:1518446152
Name:ASTUTO, ALEXA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:ASTUTO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1171 65TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-5634
Mailing Address - Country:US
Mailing Address - Phone:718-236-3394
Mailing Address - Fax:
Practice Address - Street 1:1171 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5634
Practice Address - Country:US
Practice Address - Phone:718-236-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
027928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist