Provider Demographics
NPI:1700545076
Name:KADLUBOWSKI, ALEXANDRA H (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:H
Last Name:KADLUBOWSKI
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 W 3RD AVE APT C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2925
Mailing Address - Country:US
Mailing Address - Phone:419-979-3538
Mailing Address - Fax:
Practice Address - Street 1:6000 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5073
Practice Address - Country:US
Practice Address - Phone:614-764-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011604225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist