Provider Demographics
NPI:1780469221
Name:TAYLOR, ALEXYS (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXYS
Middle Name:
Last Name:TAYLOR
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 1:1957 POWELLS LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4455
Mailing Address - Country:US
Mailing Address - Phone:703-586-8310
Mailing Address - Fax:
Practice Address - Street 1:218 N LEE ST STE 326
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2660
Practice Address - Country:US
Practice Address - Phone:703-395-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119010108225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics