Individual
ALEXA ELYSE STUBENRAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
178 VISTA GRANDE DR, PONTE VEDRA BEACH, FL 32082-1754
(717) 875-0962
Mailing address
178 VISTA GRANDE DR, PONTE VEDRA BEACH, FL 32082-1754
(717) 875-0962
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA18630
FL
235Z00000X
Speech-Language Pathologist
SZ9286
FL
Other
Enumeration date
05/22/2019
Last updated
11/08/2022
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