Provider Demographics
NPI:1831845056
Name:FENSTERER, ALISON MAE (OTR/L)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MAE
Last Name:FENSTERER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W TRADE ST APT 651
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-3384
Mailing Address - Country:US
Mailing Address - Phone:828-448-1773
Mailing Address - Fax:
Practice Address - Street 1:8133 ARDREY KELL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-5722
Practice Address - Country:US
Practice Address - Phone:704-413-0968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14826225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist