Healthcare Provider Details

I. General information

NPI: 1326535030
Provider Name (Legal Business Name): ALYSSA RAE RIEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 04/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6881 BEECHMONT AVE
CINCINNATI OH
45230-2907
US

IV. Provider business mailing address

30 BISHOPSGATE DR APT 915
CINCINNATI OH
45246-4378
US

V. Phone/Fax

Practice location:
  • Phone: 513-231-6630
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: