Provider Demographics
NPI:1932230737
Name:HOVAK, ALEXANDRA
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:
Last Name:HOVAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-9792
Mailing Address - Country:US
Mailing Address - Phone:570-966-2845
Mailing Address - Fax:570-966-9693
Practice Address - Street 1:14 S 11TH ST
Practice Address - Street 2:
Practice Address - City:MIFFLINBURG
Practice Address - State:PA
Practice Address - Zip Code:17844-9792
Practice Address - Country:US
Practice Address - Phone:570-966-2845
Practice Address - Fax:570-966-9693
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001342L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist