Provider Demographics
NPI:1770746729
Name:NAJARRO, ALEXIS VENTIMGLIA (OTR/L, CPAM)
Entity type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:VENTIMGLIA
Last Name:NAJARRO
Suffix:
Gender:F
Credentials:OTR/L, CPAM
Other - Prefix:MS
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:VENTIMGLIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:141 SAMS ST STE A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-4101
Mailing Address - Country:US
Mailing Address - Phone:404-296-8511
Mailing Address - Fax:404-296-8514
Practice Address - Street 1:141 SAMS ST STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-4101
Practice Address - Country:US
Practice Address - Phone:404-296-8511
Practice Address - Fax:404-296-8514
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004944225XH1200X, 225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics