Individual
ALEXIS LACAILLE LORICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
13590 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-1218
(703) 492-5050
Mailing address
7131 TOLLIVER ST, ALEXANDRIA, VA 22306-3503
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
Primary
0131002400
VA
225X00000X
Occupational Therapist
0131002400
VA
Other
Enumeration date
11/04/2020
Last updated
11/18/2020
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