Dittmer, Lisa Louise

Dittmer, Lisa Louise is an individual health care provider with primary practice located at 1003 Grand Avenue , West Des Moines IA 50265-3502. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dittmer, Lisa Louise can be contacted via phone (515) 267-1003.

Contact Information

Primary practice address
1003 Grand Avenue West Des Moines IA 50265-3502
Phone: (515) 267-1003
Fax: (515) 267-0100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 02271 Iowa

Profile Details

NPI number 1053389155
LBN Legal business name Dittmer, Lisa Louise
Credentials LISW
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053389155 NPPES
Iowa Other IA0127 JOHN DEERE HC
Iowa Other 49480 JOHN DEERE HC
Iowa MEDICAID 1045898 JOHN DEERE HC

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