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General NPI Number Information
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NPI Number | 1164247383
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Entity Type | Individual
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Provider Name | TERESA THISSEN OMD, LAC
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Gender | Female
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 140 W HUFFAKER LN STE 504
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City | RENO
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State | NV
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Zip | 89511-4012
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Country | US
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Telephone | 775-815-4241
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Fax |
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Provider Business Mailing Address
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Address Line | 6463 BROOKVIEW CIR
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City | RENO
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State | NV
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Zip | 89519-8320
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Country | US
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Telephone | 775-815-4241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 2504
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License Number State | NV
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