Individual
ALEXIS WHITESIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 ANNA GOODE WAY, SUFFOLK, VA 23434-9236
(757) 923-5500
Mailing address
131 S THALIA RD, VIRGINIA BEACH, VA 23452-1230
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119008860
VA
Other
Enumeration date
02/21/2020
Last updated
02/10/2021
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