Provider Demographics
NPI:1932536182
Name:ANACHEBE, ALEXANDRIA S (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:S
Last Name:ANACHEBE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:
Other - Last Name:SYLVIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT
Mailing Address - Street 1:2094 S SHERWOOD DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2279
Mailing Address - Country:US
Mailing Address - Phone:954-254-5903
Mailing Address - Fax:
Practice Address - Street 1:1221 E MCPHERSON AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2326
Practice Address - Country:US
Practice Address - Phone:229-543-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT005660225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist