Provider Demographics
NPI:1114316619
Name:WARNKEN, ALEXANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:WARNKEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6408 YORK BRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78749-2274
Mailing Address - Country:US
Mailing Address - Phone:202-213-9863
Mailing Address - Fax:
Practice Address - Street 1:6408 YORK BRIDGE CIR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-2274
Practice Address - Country:US
Practice Address - Phone:202-213-9863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117355225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist