Provider Demographics
NPI:1821514126
Name:SANDERS, PERRI ALEXANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:PERRI
Middle Name:ALEXANDRA
Last Name:SANDERS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:PERRI
Other - Middle Name:SANDERS
Other - Last Name:BROOK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:BRANTLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36009-0275
Mailing Address - Country:US
Mailing Address - Phone:334-268-0592
Mailing Address - Fax:
Practice Address - Street 1:193 SAM LISENBY RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3048
Practice Address - Country:US
Practice Address - Phone:334-445-6336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4405225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics