Provider Demographics
NPI:1750039590
Name:MAIER, ALEXIS A (OTR/L MS)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:A
Last Name:MAIER
Suffix:
Gender:F
Credentials:OTR/L MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CLOVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-9132
Mailing Address - Country:US
Mailing Address - Phone:570-675-6037
Mailing Address - Fax:
Practice Address - Street 1:5 JACQUELYN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-9107
Practice Address - Country:US
Practice Address - Phone:631-223-6713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008699225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist