Individual
HEIDI A NIESSNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MARKET ST, JOHNSTOWN, PA 15901-1608
(814) 539-1919
(814) 539-1308
Mailing address
111 MARKET ST, JOHNSTOWN, PA 15901-1608
(814) 539-1919
(814) 539-1308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL005810L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018848520001
—
PA
Enumeration date
04/18/2007
Last updated
04/22/2008
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