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General NPI Number Information
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NPI Number | 1528769437
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Entity Type | Individual
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Provider Name | ALEXA CAMPBELL OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/16/2023
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Provider Practice Location Address
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Address Line | 18740 W BLUEMOUND RD
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City | BROOKFIELD
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State | WI
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Zip | 53045-2936
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Country | US
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Telephone | 224-998-8408
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 GERTRUDE ST
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City | WAUKESHA
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State | WI
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Zip | 53186-2617
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Country | US
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Telephone | 414-324-3469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 7320-26
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License Number State | WI
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