Provider Demographics
NPI:1013674639
Name:PLITT, ALEXA PAIGE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:PAIGE
Last Name:PLITT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 PANCOAST PL
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-4734
Mailing Address - Country:US
Mailing Address - Phone:856-981-0891
Mailing Address - Fax:
Practice Address - Street 1:1501 OLD BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:BLACKWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08012-4939
Practice Address - Country:US
Practice Address - Phone:856-404-0904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00897700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist