Provider Demographics
NPI:1093470726
Name:STINE, ALEXANNA KRISTINE (OTR, MOT)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANNA
Middle Name:KRISTINE
Last Name:STINE
Suffix:
Gender:F
Credentials:OTR, MOT
Other - Prefix:MISS
Other - First Name:ALEXANNA
Other - Middle Name:KRISTINE
Other - Last Name:GODLESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:75 LIVINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4353
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:58 WEAVER VILLAGE WAY
Practice Address - Street 2:SUITE 104
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787
Practice Address - Country:US
Practice Address - Phone:828-258-8800
Practice Address - Fax:828-484-8859
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist