Provider Demographics
NPI:1548773310
Name:CARROLL, ALEXA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 WHITE SWAN WAY
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-2374
Mailing Address - Country:US
Mailing Address - Phone:267-391-6130
Mailing Address - Fax:
Practice Address - Street 1:300 PERKIOMEN AVE
Practice Address - Street 2:
Practice Address - City:SCHWENKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19473-1147
Practice Address - Country:US
Practice Address - Phone:215-896-0472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist