Provider Demographics
NPI:1750965729
Name:PARKHURST, ALEXIS KRISTEN (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:KRISTEN
Last Name:PARKHURST
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 1:234 SAWMILL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE KATRINE
Mailing Address - State:NY
Mailing Address - Zip Code:12449-5257
Mailing Address - Country:US
Mailing Address - Phone:845-430-6485
Mailing Address - Fax:
Practice Address - Street 1:234 SAWMILL RD
Practice Address - Street 2:
Practice Address - City:LAKE KATRINE
Practice Address - State:NY
Practice Address - Zip Code:12449-5257
Practice Address - Country:US
Practice Address - Phone:845-430-6485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025582-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist