Healthcare Provider Details

I. General information

NPI: 1710528054
Provider Name (Legal Business Name): ALEXANDRIA SHEPHERD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRIA SPURRIER OTR/L

II. Dates (important events)

Enumeration Date: 10/07/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 LUCIA RIVERBEND HWY
MOUNT HOLLY NC
28120-9766
US

IV. Provider business mailing address

3736 PINECREST DR
GASTONIA NC
28056-8474
US

V. Phone/Fax

Practice location:
  • Phone: 704-827-8840
  • Fax:
Mailing address:
  • Phone: 704-689-7944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15404
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: