Provider Demographics
NPI:1326817073
Name:COLEN, ALEXANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:COLEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2421 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-4914
Mailing Address - Country:US
Mailing Address - Phone:405-492-2185
Mailing Address - Fax:
Practice Address - Street 1:14715 BRISTOL PARK BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1894
Practice Address - Country:US
Practice Address - Phone:405-840-1686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5781225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist