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General NPI Number Information
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NPI Number | 1376471425
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Entity Type | Individual
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Provider Name | ALYSSA FLETCHER
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Gender | Female
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Dates
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Enumeration Date | 05/11/2026
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Last Update Date | 05/11/2026
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Provider Practice Location Address
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Address Line | 524 S CRESCENT DR
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City | KIRKWOOD
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State | MO
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Zip | 63122-4629
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Country | US
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Telephone | 314-447-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 4919 MAHAW DR
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City | IMPERIAL
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State | MO
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Zip | 63052-1371
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2026019048
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License Number State | MO
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