Provider Demographics
NPI:1578449617
Name:PRAVIA, ALEXANDER (HAS)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:PRAVIA
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ROPER CORNERS CIR STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4889
Mailing Address - Country:US
Mailing Address - Phone:864-999-0261
Mailing Address - Fax:
Practice Address - Street 1:20 ROPER CORNERS CIR STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4889
Practice Address - Country:US
Practice Address - Phone:864-999-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTP1315237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist