Provider Demographics
NPI:1841766763
Name:SHERMETARO, ALEXANDRA LOWERY (MOT, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:LOWERY
Last Name:SHERMETARO
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:LOWERY
Other - Last Name:FOSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:34505 W 12 MILE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44405 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5023
Practice Address - Country:US
Practice Address - Phone:248-858-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI52010009279225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist