Healthcare Provider Details

I. General information

NPI: 1265370472
Provider Name (Legal Business Name): ALEXANDRA KLAMM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 PHEASANT POINTE LN
OLD MONROE MO
63369-2144
US

IV. Provider business mailing address

220 PHEASANT POINTE LN
OLD MONROE MO
63369-2144
US

V. Phone/Fax

Practice location:
  • Phone: 636-695-2070
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2025053202
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: