Individual
ALEXA MIKAEL BURGEESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L, CSRS, CNS
Contact information
Practice address
4595 E HIGHWAY 20, NICEVILLE, FL 32578-8847
(850) 460-3598
Mailing address
34 AMERICAN CT, SANTA ROSA BEACH, FL 32459-5099
(740) 645-1905
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA16815
FL
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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