Provider Demographics
NPI:1063093615
Name:SELLS, ALEXANDRIA LEIGH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:LEIGH
Last Name:SELLS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LEXI
Other - Middle Name:LEIGH
Other - Last Name:SELLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:6060 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-1907
Mailing Address - Country:US
Mailing Address - Phone:317-817-5501
Mailing Address - Fax:
Practice Address - Street 1:23 CROSBY DR STE 300
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1423
Practice Address - Country:US
Practice Address - Phone:978-315-6260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13878225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist