Provider Demographics
NPI:1679129795
Name:CHRISTENSEN, ALEXI MERCEDES (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXI
Middle Name:MERCEDES
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11672 EVERGREEN ST NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-2424
Mailing Address - Country:US
Mailing Address - Phone:651-233-7436
Mailing Address - Fax:
Practice Address - Street 1:11672 EVERGREEN ST NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-2424
Practice Address - Country:US
Practice Address - Phone:651-233-7436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XF0002X, 225X00000X, 225XP0200X, 253Z00000X, 101Y00000X, 225XE0001X
WI6601-026225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & SwallowingGroup - Single Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No253Z00000XAgenciesIn Home Supportive Care
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification