Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alexis Dubose

Individual provider Occupational Therapist · NPI 1679395487

Alexis Dubose is an Occupational Therapist in Private Practice in Moncks Corner, South Carolina. Qualified in 2024, 2 years ago. Licensed in South Carolina.

Years since qualifying
2
Licensed in
SC
In the registry since
2024

Practice location Address checks out

421 Barony St Ste 3
Moncks Corner, SC 29461-3145
Phone: (843) 790-4093
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 7405 (SC)

Record details

NPI number1679395487
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 31, 2024
Last updated in NPPESOctober 31, 2024
Certification dateOctober 31, 2024
Mailing address174 Kitfield Rd, Moncks Corner, SC 29461-4209

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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