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Individual

MS. ALEXANDRA DVORAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
975 PLATTE RIVER BLVD UNIT O, BRIGHTON, CO 80601-4349
(303) 659-8822
(303) 659-7788
Mailing address
975 PLATTE RIVER BLVD UNIT O, BRIGHTON, CO 80601-4349
(303) 659-8822
(303) 659-7788

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146012138
IL
235Z00000X
Speech-Language Pathologist
Primary
SLP.0001825
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14055616
ASHA ACCOUNT NUMBER
CO
01
146012138
ILLINOIS STATE LICENSE
IL
01
SLP.0001825
STATE LICENSE NUMBER
CO
Enumeration date
08/01/2013
Last updated
08/13/2014
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