Provider Demographics
NPI:1811790991
Name:BEERS, ALLYSA WILSON (TRS, CTRS)
Entity type:Individual
Prefix:MRS
First Name:ALLYSA
Middle Name:WILSON
Last Name:BEERS
Suffix:
Gender:
Credentials:TRS, CTRS
Other - Prefix:
Other - First Name:ALLYSA
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TRS, CTRS
Mailing Address - Street 1:5500 MING AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4696
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:228 W 400 N
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:UT
Practice Address - Zip Code:84045-3102
Practice Address - Country:US
Practice Address - Phone:385-715-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6875400-4002225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
55695OtherCERTIFIED THERAPEUTIC RECREATION SPECIALIST
UT6875400-4002OtherTHERAPEUTIC RECREATION SPECIALIST