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Individual

ALEXIS BAHLOUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1401 M ST, DANVILLE, AR 72833-0277
(479) 495-7332
(479) 967-2876
Mailing address
P.O. DRAWER 2109, RUSSELLVILLE, AR 72811-2109
(479) 967-2322
(479) 967-2876

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
201967
AR
235Z00000X
Speech-Language Pathologist
Primary
202333
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287826721
AR
Enumeration date
07/22/2022
Last updated
07/14/2023
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