Alexandria Kluttz Wallace, OTD, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

16353 Issued in NC

Practice address

307 Boatner Rd Ste 114
Eglin Afb, FL 32542-1302

Phone

(850) 883-9314

NPI assigned

Oct 3, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advantage OT Inc.

  • Occupational Therapist
  • Beulaville, NC
  • NPI 1962717025
  NPD
• Advantage OT, PC

  • Occupational Therapist
  • Beulaville, NC
  • NPI 1497282479
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1386424687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 BOATNER RD STE 114",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421302",
            "telephone_number": "850-883-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALEXANDRIA",
        "middle_name": "KLUTTZ",
        "credential": "OTD, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-03",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Millard Wade, DDS
• Thomas Herbert Wagner, M.D.
• Derek Walker, MD
• Gary M Walker, M.D.
• Pamela A Walker, R.PH.
• Stephanie A Wallgren, PHARM.D.
• Adam Wallum, DMD
• Rickey H Walters Jr., LCSW
• Haley Warra
• Lance R Washburn, DDS

• Occupational Therapist in Eglin Afb, FL
• Providers in Eglin Afb, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.