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General NPI Number Information
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NPI Number | 1164314829
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Entity Type | Organization
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Legal Business Name | NEUROCAMBIO THERAPY AND CONSULTING, PLC
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 8850 NW 62ND AVE SUITE 140
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City | JOHNSTON
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State | IA
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Zip | 50131
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Country | US
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Telephone | 515-526-5805
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Fax |
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Provider Business Mailing Address
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Address Line | 646 SE WILLIAMS CT
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City | WAUKEE
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State | IA
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Zip | 50263-8395
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Country | US
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Telephone | 515-988-1646
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | DIANA CHRISTENSEN
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Credential | MS, LMHC
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Telephone | 515-988-1646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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