Provider Demographics
NPI:1932616406
Name:WILSON, ALEXANDRA PFEFFERLE (DPT, PT, OCS, ATC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PFEFFERLE
Last Name:WILSON
Suffix:
Gender:F
Credentials:DPT, PT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 METAIRIE LAWN DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-6107
Mailing Address - Country:US
Mailing Address - Phone:850-881-3913
Mailing Address - Fax:
Practice Address - Street 1:2620 METAIRIE LAWN DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6107
Practice Address - Country:US
Practice Address - Phone:504-841-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
CA3000842251X0800X
FLPT381832251X0800X
LA3060032255A2300X
LA12115R2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer