Individual
MS. ALEXANDRA FACKRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1975 GLENN MITCHELL DR, SUITE 200, VIRGINIA BEACH, VA 23456
(757) 368-3284
Mailing address
230 CLEARFIELD AVE, SUITE 124, VIRGINIA BEACH, VA 23462-1832
(757) 321-3383
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119001621
VA
225XH1200X
Hand Occupational Therapist
0119001621
VA
286500000X
Military Hospital
0119001621
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MEDICARE GROUP
C05501
VA
Enumeration date
03/01/2013
Last updated
07/23/2018
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