| Doctor Name: | MS. ALEXANNE KENNEDY CONKLIN |
| NPI Number: | 1053674234 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS.CCC/SLP |
| License Number: | SL-002762-L |
| Business Practice Address: | 185 South Mountain Blvd Mountain Top, PA - 18707 |
| Business Phone Number: | 5704746377 |
| Business Fax Number: | 5704742109 |
| Mailing Address: | Po Box 240, 8796 Route 219 BROCKWAY |
| State: | PA |
| Postal Code: | 15824 |
| Phone Number: | 8142657874 |
| Fax Number: | 8142652082 |
| NPI Enumeration Date: | 06/21/2012 |
| NPI Last Update Date: | 06/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SL-002762-L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |