Provider Demographics
NPI:1427741263
Name:WOINAROWICZ, LEXIE ANNE (OTD)
Entity type:Individual
Prefix:
First Name:LEXIE
Middle Name:ANNE
Last Name:WOINAROWICZ
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1454 MCHUGH AVE
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1776
Mailing Address - Country:US
Mailing Address - Phone:701-360-3219
Mailing Address - Fax:
Practice Address - Street 1:1454 MCHUGH AVE
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1776
Practice Address - Country:US
Practice Address - Phone:701-360-3219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107184225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist