Individual
ALEXIS BLENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
N27W5707 LINCOLN BLVD, CEDARBURG, WI 53012-2852
(262) 376-7676
(262) 376-5208
Mailing address
N27W5707 LINCOLN BLVD, CEDARBURG, WI 53012-2852
(262) 376-7676
(262) 376-5208
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5105-27
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLICATION PENDING
—
WI
Enumeration date
11/18/2014
Last updated
11/18/2014
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