Provider Demographics
NPI:1750873527
Name:TOPPEN, ALYSSA JOLENE (MSOT)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:JOLENE
Last Name:TOPPEN
Suffix:
Gender:
Credentials:MSOT
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:JOLENE
Other - Last Name:HOAGLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1221 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2701
Mailing Address - Country:US
Mailing Address - Phone:859-258-6200
Mailing Address - Fax:859-258-6203
Practice Address - Street 1:1207 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2701
Practice Address - Country:US
Practice Address - Phone:859-258-8519
Practice Address - Fax:859-258-8592
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242022225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100543180Medicaid