Healthcare Provider Details

I. General information

NPI: 1093011322
Provider Name (Legal Business Name): ERIN MARIE ALEXANDER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2011
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

467 EASTERN BY-PASS
RICHMOND KY
40475
US

IV. Provider business mailing address

12586 WESLEY CHAPEL RD
CALIFORNIA KY
41007-8640
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-6334
  • Fax:
Mailing address:
  • Phone: 859-816-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberR4279
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: