Provider Demographics
NPI:1336774827
Name:THAMES, ALAYNA PAIGE (OTR)
Entity type:Individual
Prefix:
First Name:ALAYNA
Middle Name:PAIGE
Last Name:THAMES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:ALAYNA
Other - Middle Name:PAIGE
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:521 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-1536
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:521 W 7TH ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-1536
Practice Address - Country:US
Practice Address - Phone:817-594-8713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120686225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist