Provider Demographics
NPI:1861270787
Name:BOODRY, ALEXIS (OTD)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:BOODRY
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:PARENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:60 MILK ST APT 2
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3163
Mailing Address - Country:US
Mailing Address - Phone:339-203-7724
Mailing Address - Fax:
Practice Address - Street 1:607 NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1322
Practice Address - Country:US
Practice Address - Phone:781-245-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15016225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist