Provider Demographics
NPI:1902440084
Name:ALDRIDGE, ALEXIS (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-5327
Mailing Address - Country:US
Mailing Address - Phone:919-457-3808
Mailing Address - Fax:
Practice Address - Street 1:6827 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3339
Practice Address - Country:US
Practice Address - Phone:704-817-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-01
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15520225X00000X
GAOT007566225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist