Provider Demographics
NPI:1598280703
Name:MCDONALD, ALYSSA LEEANN (OTR)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:LEEANN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 DANCE HALL LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-7473
Mailing Address - Country:US
Mailing Address - Phone:810-310-0740
Mailing Address - Fax:
Practice Address - Street 1:14070 FOLEY RD
Practice Address - Street 2:
Practice Address - City:MUSSEY
Practice Address - State:MI
Practice Address - Zip Code:48014-2000
Practice Address - Country:US
Practice Address - Phone:810-310-0740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist