Provider Demographics
NPI:1043854128
Name:VAN GINKEL, ALEXYA
Entity Type:Individual
Prefix:
First Name:ALEXYA
Middle Name:
Last Name:VAN GINKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 300TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK VALLEY
Mailing Address - State:IA
Mailing Address - Zip Code:51247-7539
Mailing Address - Country:US
Mailing Address - Phone:605-359-2222
Mailing Address - Fax:
Practice Address - Street 1:1101 9TH ST SE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-2501
Practice Address - Country:US
Practice Address - Phone:712-722-1271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-01
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087113225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist