Provider Demographics
NPI:1922882497
Name:HERMES, ALEXANDRA (OTR)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:HERMES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 MURPHYS LANDING DR APT 102
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46217-3383
Mailing Address - Country:US
Mailing Address - Phone:859-630-3690
Mailing Address - Fax:
Practice Address - Street 1:1502 MURPHYS LANDING DR APT 102
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46217-3383
Practice Address - Country:US
Practice Address - Phone:859-630-3690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31008107A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty