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NPI Code Detail

MEDICARE: ALEXIS LYNN RAU MSOT, OTRL

MEDICARE: ALEXIS LYNN RAU MSOT, OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2225X00000XOccupational Therapist
3225X00000XOccupational Therapist5201012816MI

General Provider Information

NPI Number : 1326605684
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS LYNN RAU MSOT, OTRL
Provider Business Mailing Address
First Line : 44670 ANN ARBOR RD W STE 130
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-4085
Country : US
Telephone Number : 313-278-4601
Fax Number :
Provider Business Practice Location Address
First Line : 20251 CARLYSLE ST
Second Line :
City : DEARBORN
State : MI
Zip : 48124-3804
Country : US
Telephone Number : 248-617-0345
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2019
Last Update Date : 02/14/2022

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