Individual
LISA ANN BICKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
422 MAIN ST, KLAMATH FALLS, OR 97601-6048
(541) 887-7974
Mailing address
422 MAIN ST, KLAMATH FALLS, OR 97601-6048
(541) 887-7974
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-597
OR
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500803626
—
OR
Enumeration date
05/05/2021
Last updated
09/19/2024
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