| NPI | 1528564762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA ANN GREEN Psychologist 515-450-8913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 089407) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: IA 01011) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2025-02-18 |