Provider Demographics
NPI:1831744390
Name:ADELMAN, ALEXANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ADELMAN
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 1:2515 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-4708
Mailing Address - Country:US
Mailing Address - Phone:314-974-3171
Mailing Address - Fax:
Practice Address - Street 1:6031 SOUTHWEST AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63139-2716
Practice Address - Country:US
Practice Address - Phone:314-645-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019008192225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics