MEDICARE: SUSAN GAMBILL ALEXANDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	1542	CO
2	225X00000X	Occupational Therapist	OT4386	FL

General Provider Information

NPI Number	:	1093085581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN GAMBILL ALEXANDER

Provider Business Mailing Address
First Line	:	5667 CROSS CREEK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924-8102
Country	:	US
Telephone Number	:	719-640-8165
Fax Number	:

Provider Business Practice Location Address
First Line	:	5667 CROSS CREEK DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80924-8102
Country	:	US
Telephone Number	:	719-282-8656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2011
Last Update Date	:	08/19/2025

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Directions to “ SUSAN GAMBILL ALEXANDER ” Practice Location

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