Provider Demographics
NPI:1730662719
Name:RICHARDS, ALYSSA (OT)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:STORY CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50248-1454
Mailing Address - Country:US
Mailing Address - Phone:515-450-1956
Mailing Address - Fax:
Practice Address - Street 1:212 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:STORY CITY
Practice Address - State:IA
Practice Address - Zip Code:50248-1454
Practice Address - Country:US
Practice Address - Phone:515-450-1956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist