Provider Demographics
NPI:1427761063
Name:MCARDLE, ALEXANDRA LAURA (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:LAURA
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-4595
Mailing Address - Country:US
Mailing Address - Phone:410-912-2066
Mailing Address - Fax:
Practice Address - Street 1:1336 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-4595
Practice Address - Country:US
Practice Address - Phone:410-912-2066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09864225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist