Provider Demographics
NPI:1811305816
Name:PIENTA, ALISON (LMT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:PIENTA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 S MAIN ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-1778
Mailing Address - Country:US
Mailing Address - Phone:815-879-0909
Mailing Address - Fax:815-875-3532
Practice Address - Street 1:105 S MAIN ST
Practice Address - Street 2:SUITE 7
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-1778
Practice Address - Country:US
Practice Address - Phone:815-879-0909
Practice Address - Fax:815-875-3532
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL227.012055225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist