Healthcare Provider Details

I. General information

NPI: 1841991296
Provider Name (Legal Business Name): ALEXIS BROOK WILLIAMS WEST OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 MORGANTON BLVD SW
LENOIR NC
28645-5823
US

IV. Provider business mailing address

2566 BRENTWOOD CIR
LENOIR NC
28645-9324
US

V. Phone/Fax

Practice location:
  • Phone: 828-239-9400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15514
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: