Tiedens, Alyssa Catherine
Tiedens, Alyssa Catherine is an individual health care provider with primary practice located at 9177 Oakview Ln N , Maple Grove MN 55369-6505. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Tiedens, Alyssa Catherine can be contacted via phone (763) 232-6394.Contact Information
Primary practice address
9177 Oakview Ln N
Maple Grove MN 55369-6505
Phone: (763) 232-6394
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | 2859 | Minnesota |
Profile Details
| NPI number | 1346786761 |
|---|---|
| LBN Legal business name | Tiedens, Alyssa Catherine |
| Credentials | MS, ATC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2017 |
| Last updated | Apr 25th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346786761 | NPPES |
| Other | 2000014006 | BOARD OF CERTIFICATION |
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