Provider Demographics
NPI:1083003297
Name:BASSETT, ALETHIA
Entity Type:Individual
Prefix:
First Name:ALETHIA
Middle Name:
Last Name:BASSETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 BRICKYARD BLVD
Mailing Address - Street 2:APT 2067
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1328
Mailing Address - Country:US
Mailing Address - Phone:757-561-4418
Mailing Address - Fax:
Practice Address - Street 1:700 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6058
Practice Address - Country:US
Practice Address - Phone:202-683-2838
Practice Address - Fax:202-318-8036
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010000980171W00000X
MD07620225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No171W00000XOther Service ProvidersContractor