Provider Demographics
NPI:1760627806
Name:ELLIOTT, ALEXANDRA SPIGELMYER (OTR)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:SPIGELMYER
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 ROSE HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLDSPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77331-7413
Mailing Address - Country:US
Mailing Address - Phone:936-520-6604
Mailing Address - Fax:
Practice Address - Street 1:61 CHURCH ST.
Practice Address - Street 2:
Practice Address - City:COLDSPRING
Practice Address - State:TX
Practice Address - Zip Code:77331
Practice Address - Country:US
Practice Address - Phone:936-520-6604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112401225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist