Provider Demographics
NPI:1760994065
Name:DEMPSEY, ALEXA RAE
Entity Type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:RAE
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 DUNEDIN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-7866
Mailing Address - Country:US
Mailing Address - Phone:813-482-6165
Mailing Address - Fax:
Practice Address - Street 1:415 DUNEDIN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-7866
Practice Address - Country:US
Practice Address - Phone:813-482-6165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist