Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1033674486 |
---|---|
Provider Name | Alexa Hanley |
First Address | Wilsonville, OR 97070-9697 |
Second Address | Anchorage, AK 99504-1480 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2019 |
Last Update Date | 08/02/2019 |