Provider Demographics
NPI:1922513464
Name:HENSLEY, ALYSSA KAYLEE (PTA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KAYLEE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NE 80TH PL
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-8214
Mailing Address - Country:US
Mailing Address - Phone:816-716-5397
Mailing Address - Fax:
Practice Address - Street 1:2609 GLENN HENDREN DR # G100
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-3313
Practice Address - Country:US
Practice Address - Phone:816-656-2998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017024965225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant