Basic Information
| Provider Information | |||||||||
| NPI: | 1952023483 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAKIS | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | LAUREN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75733 PORTABELLA LN | ||||||||
| Address2: | |||||||||
| City: | BRUCE TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480652530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5863374447 | ||||||||
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| Practice Location | |||||||||
| Address1: | 25615 N RANCH GATE RD | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852552141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805027726 | ||||||||
| FaxNumber: | 4805134628 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2022 | ||||||||
| LastUpdateDate: | 10/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 468240 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.