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General NPI Number Information
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NPI Number | 1194348532
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Entity Type | Individual
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Provider Name | JENNIFER MARIE KALISZ LISW
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Gender | Female
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Dates
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Enumeration Date | 05/20/2020
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2501 S CENTER ST
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City | MARSHALLTOWN
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State | IA
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Zip | 50158-4562
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Country | US
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Telephone | 641-753-1289
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Fax |
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Provider Business Mailing Address
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Address Line | 901 36TH ST SW
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City | BONDURANT
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State | IA
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Zip | 50035-6828
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Country | US
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Telephone | 319-929-7988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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