Provider Demographics
NPI:1033754056
Name:DANIELL, ALEXA MELAINE (MHS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:MELAINE
Last Name:DANIELL
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:ALEXA
Other - Middle Name:MELAINE
Other - Last Name:ROYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS, OTR/L
Mailing Address - Street 1:4212 CORAL PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520
Mailing Address - Country:US
Mailing Address - Phone:912-342-8875
Mailing Address - Fax:912-342-8016
Practice Address - Street 1:4212 CORAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520
Practice Address - Country:US
Practice Address - Phone:912-342-8875
Practice Address - Fax:912-342-8016
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCOT.5729225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics