Provider Demographics
NPI:1871743823
Name:BURNS, ALEXANDRA D (OTR L)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:D
Last Name:BURNS
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 1:3188 LUTHER LN
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-2172
Mailing Address - Country:US
Mailing Address - Phone:573-686-3845
Mailing Address - Fax:573-727-2460
Practice Address - Street 1:825 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1222
Practice Address - Country:US
Practice Address - Phone:573-223-7426
Practice Address - Fax:573-223-2932
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO005455225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist