Provider Demographics
NPI:1184249542
Name:TIEMANN, CASSANDRA (MT)
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:TIEMANN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3004
Mailing Address - Country:US
Mailing Address - Phone:320-631-0258
Mailing Address - Fax:320-631-0259
Practice Address - Street 1:220 1ST ST SE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3004
Practice Address - Country:US
Practice Address - Phone:320-631-0258
Practice Address - Fax:320-631-0259
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist