Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | DH071760 | PA |
N | 124Q00000X | Dental Hygienist | DHA002013 | PA |
N | 124Q00000X | Dental Hygienist | PHDH000970 | PA |
N | 126800000X | Dental Assistant | DF004742 | PA |
N | 225700000X | Massage Therapist | MSG013114 | PA |
NPI | 1063950251 |
---|---|
Provider Name | Mrs. Alyssa Marie Stiles |
First Address | Pittsburgh, PA 15206-4409 |
Second Address | Pittsburgh, PA 15206-4409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2017 |
Last Update Date | 23/06/2021 |