Alexandra Elizabeth Loy

Individual provider Active NPI Developmental Therapist · Beaverville, IL

NPI 1700436755 · NPPES record last updated Sep 11, 2019

Key facts

NPI
1700436755
Entity type
Individual (NPI type 1)
Primary specialty
Developmental Therapist 222Q00000X
Practice address
2803 E 2900 North Rd
Beaverville, IL 60912-7051
Phone
(815) 216-8742
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Yes

Addresses

Primary practice location

2803 E 2900 North Rd
Beaverville, IL 60912-7051

Mailing address

2803 E 2900 North Rd
Beaverville, IL 60912-7051
Phone (815) 216-8742

Sources for this page

Verify at the official NPI Registry.