MEDICARE: ALEXANDRA TOCIO OT/CHT

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
1	225X00000X	Occupational Therapist
2	225XH1200X	Hand Occupational Therapist

General Provider Information

NPI Number	:	1841235496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA TOCIO OT/CHT

Provider Business Mailing Address
First Line	:	8259 WICKER AVE
Second Line	:
City	:	SAINT JOHN
State	:	IN
Zip	:	46373-8878
Country	:	US
Telephone Number	:	219-365-6560
Fax Number	:	219-365-6561

Provider Business Practice Location Address
First Line	:	1901 PHOENIX BLVD
Second Line	:	SUITE 120
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-5588
Country	:	US
Telephone Number	:	404-355-6548
Fax Number	:	770-996-7299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/16/2008

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