Provider Demographics
NPI:1477147445
Name:ALONSO, MARIA JOSEFA (OT/L)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JOSEFA
Last Name:ALONSO
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 MASON HEADLEY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2326
Mailing Address - Country:US
Mailing Address - Phone:859-259-3486
Mailing Address - Fax:
Practice Address - Street 1:700 MASON HEADLEY RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2326
Practice Address - Country:US
Practice Address - Phone:859-259-3486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist