Provider Demographics
NPI:1295188472
Name:ALEXANDER, JULIE A (OT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10777 NALL AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1362
Mailing Address - Country:US
Mailing Address - Phone:913-279-0243
Mailing Address - Fax:913-279-0564
Practice Address - Street 1:10777 NALL AVE
Practice Address - Street 2:STE 300
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1362
Practice Address - Country:US
Practice Address - Phone:913-279-0243
Practice Address - Fax:913-279-0564
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02193225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO002760OtherMO OT LICENSE
17-02193OtherOT LICENSE