Provider Demographics
NPI:1184488264
Name:SPENCER-STEWART, ALYSON KATE
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:KATE
Last Name:SPENCER-STEWART
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 1:7653 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3654
Mailing Address - Country:US
Mailing Address - Phone:913-633-2433
Mailing Address - Fax:
Practice Address - Street 1:8340 MISSION RD UNIT B
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1355
Practice Address - Country:US
Practice Address - Phone:913-213-3531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-06086225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist