Provider Demographics
NPI:1861217531
Name:OTWORTH-WHITE, ALEXIS (OTR/L)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:OTWORTH-WHITE
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 1:869 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1341
Mailing Address - Country:US
Mailing Address - Phone:740-804-7926
Mailing Address - Fax:
Practice Address - Street 1:60 MARIETTA RD
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9433
Practice Address - Country:US
Practice Address - Phone:740-772-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011407225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation