Individual
ALISA NIEHUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
786 D STREET, JBER, AK 99505
(907) 384-0405
Mailing address
1060 GAFFNEY RD STOP 7440, FT WAINWRIGHT, AK 99703-5007
(907) 361-5603
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60423677
WA
Other
Enumeration date
12/09/2008
Last updated
11/05/2019
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