Provider Demographics
NPI:1780932038
Name:BUSLEE, ALEXIA (OTR)
Entity type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:BUSLEE
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 1:8846 AVIARY PATH
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077-4446
Mailing Address - Country:US
Mailing Address - Phone:651-214-9990
Mailing Address - Fax:
Practice Address - Street 1:8846 AVIARY PATH
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55077-4446
Practice Address - Country:US
Practice Address - Phone:651-214-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-16
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN102549225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist