Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TE1100X | Exercise & Sports Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TH0004X | Health Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1447466693 |
---|---|
Provider Name | Dr. John Joseph Hiesberger |
First Address | Columbia, MO 65203-3622 |
Second Address | Columbia, MO 65203-3622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |