Provider Demographics
NPI:1427722792
Name:DEGREEF, LEXI PAIGE (COTA/L)
Entity type:Individual
Prefix:
First Name:LEXI
Middle Name:PAIGE
Last Name:DEGREEF
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W WARNER RD APT 2019
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-7031
Mailing Address - Country:US
Mailing Address - Phone:309-642-0785
Mailing Address - Fax:
Practice Address - Street 1:3320 N CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-1104
Practice Address - Country:US
Practice Address - Phone:480-472-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTA-D46932224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant