Healthcare Provider Details

I. General information

NPI: 1740190099
Provider Name (Legal Business Name): AUDREY RAYAL SKJEIE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

103 E STATE ST STE 301
MASON CITY IA
50401-3309
US

IV. Provider business mailing address

103 E STATE ST STE 301
MASON CITY IA
50401-3309
US

V. Phone/Fax

Practice location:
  • Phone: 641-421-2089
  • Fax: 641-450-0030
Mailing address:
  • Phone: 641-421-2089
  • Fax: 641-450-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number140753
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: