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NPI Code Detail

MEDICARE: ALEXYS LORRAINE ANDERSON OTRL

MEDICARE: ALEXYS LORRAINE ANDERSON 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
1225X00000XOccupational Therapist5201013774MI

General Provider Information

NPI Number : 1558129460
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXYS LORRAINE ANDERSON OTRL
Provider Business Mailing Address
First Line : 1583 CAPAC RD
Second Line :
City : BERLIN
State : MI
Zip : 48002-2402
Country : US
Telephone Number : 586-651-1345
Fax Number :
Provider Business Practice Location Address
First Line : 30701 BARRINGTON ST STE 150
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-5135
Country : US
Telephone Number : 248-965-3916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2024
Last Update Date : 03/06/2024

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