Provider Demographics
NPI:1144869868
Name:SAXTON, ELISE (OT)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:SAXTON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:BOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:348 SPARROW WOOD CT
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5921
Mailing Address - Country:US
Mailing Address - Phone:772-646-1365
Mailing Address - Fax:
Practice Address - Street 1:348 SPARROW WOOD CT
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5921
Practice Address - Country:US
Practice Address - Phone:772-646-1365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-28
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT0003136225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist