Provider Demographics
NPI:1730923020
Name:LINK, ALEXANDRA D
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:D
Last Name:LINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:LINK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:312 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-7884
Mailing Address - Country:US
Mailing Address - Phone:417-499-3545
Mailing Address - Fax:
Practice Address - Street 1:318 CEDAR ST
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-1227
Practice Address - Country:US
Practice Address - Phone:816-540-3161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024021215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist