Provider Demographics
NPI:1770322604
Name:YOON, ALEXIS RAEANN
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:RAEANN
Last Name:YOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:RAEANN
Other - Last Name:SIZELOVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1699 CHATHAM PKWY APT 115A
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7640
Mailing Address - Country:US
Mailing Address - Phone:765-810-7191
Mailing Address - Fax:
Practice Address - Street 1:127 CARTER ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3753
Practice Address - Country:US
Practice Address - Phone:917-756-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP013050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist