| NPI | 1922607936 |
|---|---|
| Former Name | ALISSE ANNA DIERS HEIDERSCHEIT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202108253NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 202105516NP-PP) |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2023-02-23 |