Individual
ALEXA MACKENZIE PONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 EDWIN ST, MORGANTOWN, WV 26501-8505
(304) 292-0173
Mailing address
198 ULLERY RD, CARMICHAELS, PA 15320-2448
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0848
WV
235Z00000X
Speech-Language Pathologist
Primary
2193
WV
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
08/25/2020
Last updated
08/03/2021
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