Provider Demographics
NPI:1043661705
Name:BASSETT, ALENAH JANE (PTA)
Entity type:Individual
Prefix:
First Name:ALENAH
Middle Name:JANE
Last Name:BASSETT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12701 NW 98TH ST
Mailing Address - Street 2:
Mailing Address - City:MALCOLM
Mailing Address - State:NE
Mailing Address - Zip Code:68402-9687
Mailing Address - Country:US
Mailing Address - Phone:402-416-0537
Mailing Address - Fax:
Practice Address - Street 1:12701 NW 98TH ST
Practice Address - Street 2:
Practice Address - City:MALCOLM
Practice Address - State:NE
Practice Address - Zip Code:68402-9687
Practice Address - Country:US
Practice Address - Phone:402-416-0537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1480225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant