Provider Demographics
NPI:1437874245
Name:JONES, ALEXANDRA (OTRL)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40500 ANN ARBOR RD E STE 200
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4483
Mailing Address - Country:US
Mailing Address - Phone:734-369-6002
Mailing Address - Fax:
Practice Address - Street 1:40500 ANN ARBOR RD E STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4483
Practice Address - Country:US
Practice Address - Phone:734-369-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist