Individual
ALEXANDRA ELAINE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR
Contact information
Practice address
1212 S 2ND ST, DEKALB, IL 60115-4435
(815) 758-8151
Mailing address
6216 BROKENHURST RD, INDIANAPOLIS, IN 46220-4932
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31006884A
IN
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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