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General NPI Number Information
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NPI Number | 1609461623
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Entity Type | Individual
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Provider Name | ALLISSA MARIE HUGHES
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 4025 NE LAKEWOOD WAY STE 100
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City | LEES SUMMIT
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State | MO
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Zip | 64064-2058
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Country | US
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Telephone | 816-598-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 E SOUTH AVE
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City | INDEPENDENCE
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State | MO
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Zip | 64050-4757
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Country | US
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Telephone | 816-945-2708
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2013003225
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License Number State | MO
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