Provider Demographics
NPI:1790562890
Name:ALEXANDER, EMILI BLANTON (OTD)
Entity Type:Individual
Prefix:
First Name:EMILI
Middle Name:BLANTON
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 ARCHDALE RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1601
Mailing Address - Country:US
Mailing Address - Phone:205-299-4141
Mailing Address - Fax:
Practice Address - Street 1:3821 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1981
Practice Address - Country:US
Practice Address - Phone:703-294-6875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist