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Individual

ALEXIS TATTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2407 KENTUCKY ST, LOUISIANA, MO 63353-2503
(573) 754-5456
Mailing address
19766 SAGO 3, WARBA, MN 55793-1610
(218) 256-9477

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
086494
IA
225X00000X
Occupational Therapist
Primary
105362
MN
225X00000X
Occupational Therapist
2018005948
MO
225X00000X
Occupational Therapist
6247-26
WI
225X00000X
Occupational Therapist
OTP-OT-LIC-6137
MT

Other

Enumeration date
10/05/2018
Last updated
10/05/2018
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