Provider Demographics
NPI:1831330539
Name:WOROBEL, ALEXANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:WOROBEL
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 1:4135 SPRING COVE WAY
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-7831
Mailing Address - Country:US
Mailing Address - Phone:954-592-9659
Mailing Address - Fax:
Practice Address - Street 1:2848 PLEASANT RD
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-9490
Practice Address - Country:US
Practice Address - Phone:954-592-9659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8685225X00000X, 225X00000X
SC4429225X00000X, 225X00000X
FLOT 13554225X00000X
DEU1-0001667225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000699300Medicaid
NC1831330539Medicaid