Healthcare Provider Details

I. General information

NPI: 1841236841
Provider Name (Legal Business Name): HEIDI LYNN VERMEER-QUIST PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEIDI LYNN QUIST PSYD

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 AURORA AVE STE 302W
URBANDALE IA
50322-2800
US

IV. Provider business mailing address

2611 WASHINGTON STREET
PELLA IA
50219
US

V. Phone/Fax

Practice location:
  • Phone: 515-331-0303
  • Fax: 515-331-9086
Mailing address:
  • Phone: 641-628-9599
  • Fax: 641-621-1493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00965
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: