Provider Demographics
NPI:1083440770
Name:WEST, ALYSSA SHIANN (COTA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:SHIANN
Last Name:WEST
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45013 DAHL AVE
Mailing Address - Street 2:
Mailing Address - City:HAYTI
Mailing Address - State:SD
Mailing Address - Zip Code:57241-5214
Mailing Address - Country:US
Mailing Address - Phone:605-880-4985
Mailing Address - Fax:
Practice Address - Street 1:323 SW 10TH ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:SD
Practice Address - Zip Code:57042-3200
Practice Address - Country:US
Practice Address - Phone:605-256-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant