Individual
ALEXA HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1414 59TH ST S, GULFPORT, FL 33707-3352
(615) 477-1900
Mailing address
7880 54TH AVE N LOT 23, ST PETERSBURG, FL 33709-2366
(615) 477-1900
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18936
FL
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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