Provider Demographics
NPI:1619445582
Name:ALEXANDER, ANNALEE (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:ANNALEE
Middle Name:
Last Name:ALEXANDER
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 1:2121 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3658
Mailing Address - Country:US
Mailing Address - Phone:517-787-4150
Mailing Address - Fax:517-787-3074
Practice Address - Street 1:2121 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-3658
Practice Address - Country:US
Practice Address - Phone:517-787-4150
Practice Address - Fax:517-787-3074
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201006662225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist