Provider Demographics
NPI:1265774624
Name:COATES, ALEXANDRIA (MA, OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:
Last Name:COATES
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9470 ANNAPOLIS RD
Mailing Address - Street 2:416
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3025
Mailing Address - Country:US
Mailing Address - Phone:301-577-4333
Mailing Address - Fax:301-577-5180
Practice Address - Street 1:9470 ANNAPOLIS RD
Practice Address - Street 2:416
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3025
Practice Address - Country:US
Practice Address - Phone:301-577-4333
Practice Address - Fax:301-577-5180
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06865225X00000X
DCOT010000797225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist