Individual
ALEXIS MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CF-SLP
Contact information
Practice address
304 LAUREL DR, SOUTH JACKSONVILLE, IL 62650-3407
(217) 473-6569
Mailing address
304 LAUREL DR, SOUTH JACKSONVILLE, IL 62650-3407
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245836
—
IL
Enumeration date
08/05/2021
Last updated
08/05/2021
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