1336415520 NPI number — MRS. ALEXANDRA G CAYIAS M.S. CCC-SLP

Table of content: MRS. ALEXANDRA G CAYIAS M.S. CCC-SLP (NPI 1336415520)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336415520 NPI number — MRS. ALEXANDRA G CAYIAS M.S. CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAYIAS
Provider First Name:
ALEXANDRA
Provider Middle Name:
G
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S. CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GEORGOPOULOS
Provider Other First Name:
ALEXANDRA
Provider Other Middle Name:
MARIA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S. CFY-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336415520
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
127 S 500 E
Provider Second Line Business Mailing Address:
600
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84102-1959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-587-6336
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5770 S 250 E
Provider Second Line Business Practice Location Address:
G50
Provider Business Practice Location Address City Name:
MURRAY
Provider Business Practice Location Address State Name:
UT
Provider Business Practice Location Address Postal Code:
84107-8100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
801-314-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/01/2012

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  8005589-4102 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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