Provider Demographics
NPI:1356144604
Name:HENDRIXSON, ALYSSON THOMAS (L/OTR)
Entity type:Individual
Prefix:
First Name:ALYSSON
Middle Name:THOMAS
Last Name:HENDRIXSON
Suffix:
Gender:
Credentials:L/OTR
Other - Prefix:
Other - First Name:ALYSSON
Other - Middle Name:ARLENE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1086 WATSON SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-2611
Mailing Address - Country:US
Mailing Address - Phone:318-348-1751
Mailing Address - Fax:
Practice Address - Street 1:205 CIRCLE DR
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5305
Practice Address - Country:US
Practice Address - Phone:318-381-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA345158225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist