MEDICARE: ALYSSA HALLSWORTH 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
1	225X00000X	Occupational Therapist	2138	AZ

General Provider Information

NPI Number	:	1336968114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA HALLSWORTH OTR/L

Provider Business Mailing Address
First Line	:	31 ANNAPOLIS DR
Second Line	:
City	:	SICKLERVILLE
State	:	NJ
Zip	:	08081-4324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	355 N WILMOT RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2601
Country	:	US
Telephone Number	:	510-633-4389
Fax Number	:

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

Provider Enumeration Date	:	10/08/2024
Last Update Date	:	01/20/2026

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