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NPI Code Detail

MEDICARE: ALEXIS JOELLE MARSHALL

MEDICARE: ALEXIS JOELLE MARSHALL
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
1224Z00000XOccupational Therapy Assistant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1891359733
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXIS JOELLE MARSHALL
Provider Business Mailing Address
First Line : 124 GREENVIEW ST
Second Line :
City : WOOD RIVER
State : IL
Zip : 62095-3218
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1021 W E ST
Second Line :
City : BELLEVILLE
State : IL
Zip : 62220-1055
Country : US
Telephone Number : 618-791-3073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2019
Last Update Date : 04/25/2019

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Directions to “ ALEXIS JOELLE MARSHALL ” Practice Location

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