Healthcare Provider Details

I. General information

NPI: 1144808684
Provider Name (Legal Business Name): ALEXA NICOLE MARTINI OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6710A ROCKLEDGE DR STE 130
BETHESDA MD
20817-2843
US

IV. Provider business mailing address

6710A ROCKLEDGE DR STE 130
BETHESDA MD
20817-2843
US

V. Phone/Fax

Practice location:
  • Phone: 301-515-0900
  • Fax: 240-912-2381
Mailing address:
  • Phone: 301-515-0900
  • Fax: 240-912-2381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number9253
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number9253
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: