Provider Demographics
NPI:1245451517
Name:ALEXANDER, MARY SAUNCIRAE (PTA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:SAUNCIRAE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PTA
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Mailing Address - Street 1:414 N BELNORD AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-1203
Mailing Address - Country:US
Mailing Address - Phone:410-563-2077
Mailing Address - Fax:
Practice Address - Street 1:301 SAINT PAUL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-332-9688
Practice Address - Fax:410-659-5697
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD1282A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant