Provider Demographics
NPI:1457590648
Name:ALEXANDER, WENDY R (OTR)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:R
Last Name:ALEXANDER
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 1:16129 E RICE PL APT A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-6985
Mailing Address - Country:US
Mailing Address - Phone:720-232-5636
Mailing Address - Fax:
Practice Address - Street 1:16129 E RICE PL APT A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-6985
Practice Address - Country:US
Practice Address - Phone:720-232-5636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1692174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist