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General NPI Number Information
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NPI Number | 1720425853
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Entity Type | Individual
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Provider Name | ALEXI WILSON MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 3105 18TH ST
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City | METAIRIE
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State | LA
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Zip | 70002-4904
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Country | US
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Telephone | 504-866-6990
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Fax | 504-866-6991
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Provider Business Mailing Address
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Address Line | 101 RIVER RD STE 112
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City | JEFFERSON
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State | LA
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Zip | 70121-4226
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Country | US
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Telephone | 504-866-6990
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Fax | 504-866-6991
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OTT.200838
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License Number State | LA
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