Individual
ALEXIS RAE MIKULEWICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1229 TOTEROS DR # 28173, WAXHAW, NC 28173-6950
(704) 649-4509
Mailing address
1310 SAN GABRIEL AVE, CHARLOTTE, NC 28214-3104
(631) 552-1896
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16705
NC
Other
Enumeration date
04/17/2024
Last updated
06/13/2024
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