Provider Demographics
NPI:1164810479
Name:HUTCHASON, ALISHA LEE
Entity Type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:LEE
Last Name:HUTCHASON
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 1:5916 TIPPERARY ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-7286
Mailing Address - Country:US
Mailing Address - Phone:702-528-1167
Mailing Address - Fax:
Practice Address - Street 1:5916 TIPPERARY ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-7286
Practice Address - Country:US
Practice Address - Phone:702-528-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1167224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant