Provider Demographics
NPI:1922814029
Name:MEINHOLD, ALYSSA LEIGH
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LEIGH
Last Name:MEINHOLD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 LECOURE LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-7029
Mailing Address - Country:US
Mailing Address - Phone:509-680-3492
Mailing Address - Fax:
Practice Address - Street 1:958 LECOURE LN
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-7029
Practice Address - Country:US
Practice Address - Phone:509-680-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5439171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter