Healthcare Provider Details

I. General information

NPI: 1659283992
Provider Name (Legal Business Name): JALYN BUTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 48TH ST
DES MOINES IA
50310-1948
US

IV. Provider business mailing address

5406 MERLE HAY RD
JOHNSTON IA
50131-1209
US

V. Phone/Fax

Practice location:
  • Phone: 515-280-5332
  • Fax:
Mailing address:
  • Phone: 515-727-8750
  • Fax: 515-727-8757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number139804
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: