Provider Demographics
NPI:1871077552
Name:O'DONNELL, ALEXANDRA DAHLEM (MS)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:DAHLEM
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 KERSTEN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-3125
Mailing Address - Country:US
Mailing Address - Phone:713-973-1900
Mailing Address - Fax:713-973-1970
Practice Address - Street 1:1900 KERSTEN DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-3125
Practice Address - Country:US
Practice Address - Phone:713-973-1900
Practice Address - Fax:713-973-1970
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty