Provider Demographics
NPI:1376130203
Name:CARPER, ALEXANDRIA (OT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:CARPER
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 1:817 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-1235
Mailing Address - Country:US
Mailing Address - Phone:217-779-1299
Mailing Address - Fax:
Practice Address - Street 1:817 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1235
Practice Address - Country:US
Practice Address - Phone:217-779-1299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2020-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61126247225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist