Provider Demographics
NPI:1346022894
Name:USSELMAN, ALEXANDER JOHN (OTD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOHN
Last Name:USSELMAN
Suffix:
Gender:M
Credentials:OTD
Other - Prefix:
Other - First Name:ALEX
Other - Middle Name:JOHN
Other - Last Name:USSELMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD
Mailing Address - Street 1:16513 CLIFTON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-2340
Mailing Address - Country:US
Mailing Address - Phone:419-602-9335
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT012585225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist