Provider Demographics
NPI:1033674262
Name:KESSENS, ALEXANDRIA (OTD, OTR)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:KESSENS
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6819 VALLEY RIDGE LN APT 2B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-8269
Mailing Address - Country:US
Mailing Address - Phone:812-593-7306
Mailing Address - Fax:
Practice Address - Street 1:9919 TOWNE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-8260
Practice Address - Country:US
Practice Address - Phone:317-872-4166
Practice Address - Fax:317-872-3234
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31006787A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty