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General NPI Number Information
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NPI Number | 1972315562
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Entity Type | Organization
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Legal Business Name | AXXIS WELLNESS AT HOME
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 17 HAZEL TER
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City | WOODBRIDGE
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State | CT
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Zip | 06525-2209
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Country | US
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Telephone | 475-434-1672
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Fax | 877-530-0745
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Provider Business Mailing Address
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Address Line | PO BOX 4450
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City | HAMDEN
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State | CT
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Zip | 06514-0450
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Country | US
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Telephone | 475-434-1672
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Fax | 877-530-0745
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Authorized Official
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Title or Position | OWNER, OCCUPATIONAL THERAPIST
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Name | TAJHMA BURROUGHS
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Credential | OTR/L
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Telephone | 475-434-1672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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