Provider Demographics
NPI:1154108140
Name:ALEXANDER, HARNITHA M (OTA)
Entity type:Individual
Prefix:
First Name:HARNITHA
Middle Name:M
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 KELSALL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:GA
Mailing Address - Zip Code:31324-7713
Mailing Address - Country:US
Mailing Address - Phone:912-202-9103
Mailing Address - Fax:
Practice Address - Street 1:127 CARTER ST
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:GA
Practice Address - Zip Code:31324-3753
Practice Address - Country:US
Practice Address - Phone:912-756-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA000347224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant