Provider Demographics
NPI:1366912719
Name:WISNESS, ALYSA BELLE (RBT - REGISTERED BEH)
Entity type:Individual
Prefix:
First Name:ALYSA
Middle Name:BELLE
Last Name:WISNESS
Suffix:
Gender:F
Credentials:RBT - REGISTERED BEH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 HICKMAN MILLS DR BLDG II
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-1618
Mailing Address - Country:US
Mailing Address - Phone:816-501-5138
Mailing Address - Fax:816-777-0626
Practice Address - Street 1:9153 W 133RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4333
Practice Address - Country:US
Practice Address - Phone:913-257-5185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician