Healthcare Provider Details

I. General information

NPI: 1881198471
Provider Name (Legal Business Name): ALEXANDRA VONBEHREN BUCK MOT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 S ROCHESTER RD
ROCHESTER HILLS MI
48307-3534
US

IV. Provider business mailing address

5798 HIGHLAND RD
WATERFORD MI
48327-1826
US

V. Phone/Fax

Practice location:
  • Phone: 248-218-5150
  • Fax: 248-218-5155
Mailing address:
  • Phone: 248-724-4400
  • Fax: 248-724-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number5201010152
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number008267
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: