Provider Demographics
NPI:1760583330
Name:DRAPEAUX, ALISA (DPT)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:DRAPEAUX
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:SCHONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:2507 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50311-4516
Mailing Address - Country:US
Mailing Address - Phone:515-271-2011
Mailing Address - Fax:
Practice Address - Street 1:2507 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-4516
Practice Address - Country:US
Practice Address - Phone:515-271-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665430Medicaid
IA0665430Medicaid
IAI19172067Medicare PIN
IA16-6583Medicare ID - Type Unspecified