| NPI | 1386263747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANUARY KIM Practice Owner 515-419-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-04-15 |