MEDICARE: MRS. ALISHA LEE HUTCHASON

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
1	224Z00000X	Occupational Therapy Assistant	1167	NV

General Provider Information

NPI Number	:	1164810479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISHA LEE HUTCHASON

Provider Business Mailing Address
First Line	:	5916 TIPPERARY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-7286
Country	:	US
Telephone Number	:	702-528-1167
Fax Number	:

Provider Business Practice Location Address
First Line	:	5916 TIPPERARY ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-7286
Country	:	US
Telephone Number	:	702-528-1167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2015
Last Update Date	:	01/08/2015

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