Healthcare Provider Details

I. General information

NPI: 1831744390
Provider Name (Legal Business Name): ALEXANDRA ADELMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 SOUTHWEST AVE
SAINT LOUIS MO
63139-2716
US

IV. Provider business mailing address

2515 PIONEER DR
SAINT LOUIS MO
63129-4708
US

V. Phone/Fax

Practice location:
  • Phone: 314-645-1201
  • Fax:
Mailing address:
  • Phone: 314-974-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number2019008192
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: