Provider Demographics
NPI:1881187516
Name:SPRINGHETTI, ALEXANDRA MARIE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:SPRINGHETTI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:GILLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:3127 TEAL AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40213-1149
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 DIAGNOSTIC DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6556
Practice Address - Country:US
Practice Address - Phone:502-607-8910
Practice Address - Fax:877-667-1254
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY166958225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist