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NPI Code Detail

MEDICARE: ALYSSA KASCHAK MOT, OTR/L

MEDICARE:   ALYSSA  KASCHAK  MOT, OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist120311TX

General Provider Information

NPI Number : 1205477197
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA KASCHAK MOT, OTR/L
Provider Business Mailing Address
First Line : PO BOX 852647
Second Line :
City : RICHARDSON
State : TX
Zip : 75085-2647
Country : US
Telephone Number : 972-454-9309
Fax Number : 972-338-9378
Provider Business Practice Location Address
First Line : 1771 INTERNATIONAL PKWY STE 107
Second Line :
City : RICHARDSON
State : TX
Zip : 75081-1865
Country : US
Telephone Number : 972-454-9309
Fax Number : 972-338-9378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2019
Last Update Date : 10/02/2019

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Directions to “ ALYSSA KASCHAK MOT, OTR/L” Practice Location

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