Provider Demographics
NPI:1396318150
Name:SEARLE, ALEXIS ANN (OT)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ANN
Last Name:SEARLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3546 W MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-2766
Mailing Address - Country:US
Mailing Address - Phone:208-670-4885
Mailing Address - Fax:
Practice Address - Street 1:449 S FITNESS PL
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6828
Practice Address - Country:US
Practice Address - Phone:208-670-4885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist