Provider Demographics
NPI:1295286847
Name:CHESNEY, ALYSSE (OTR/L)
Entity type:Individual
Prefix:
First Name:ALYSSE
Middle Name:
Last Name:CHESNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 PEACOCK PL
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-0903
Mailing Address - Country:US
Mailing Address - Phone:732-575-5707
Mailing Address - Fax:
Practice Address - Street 1:92 PEACOCK PL
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-0903
Practice Address - Country:US
Practice Address - Phone:732-575-5707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020993-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist