Provider Demographics
NPI:1831487768
Name:WRIGHT, ALEXANDRIA (OTA)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7387 HAWKS BRANCH CT
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-2845
Mailing Address - Country:US
Mailing Address - Phone:904-654-8917
Mailing Address - Fax:
Practice Address - Street 1:7387 HAWKS BRANCH CT
Practice Address - Street 2:OPTIONAL
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222-2845
Practice Address - Country:US
Practice Address - Phone:904-654-8917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11578224Z00000X
FL11714224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant