Individual provider · NPI-1

Alex Elizabeth Bahl

Speech-Language Pathologist, · Joplin, MO

NPI number1790456259
StatusActive
Last updated in NPPESSep 24, 2021

Details

NPI
1790456259
Entity type
Individual (NPI-1)
Name
Alex Elizabeth Bahl
Sex
Female
Sole proprietor
No
Enumeration date
Sep 24, 2021
Certification date
Sep 8, 2021
Last updated
Sep 24, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,2021032822MOYes

Practice location

130 S Mckinley Ave
Joplin, MO 64801-3211

Phone 417-489-0654

Mailing address

825 Pearl Ave
Joplin, MO 64801

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