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General NPI Number Information
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NPI Number | 1407864176
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Entity Type | Individual
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Provider Name | REBECCA RAE MONSMA LISW
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Gender | Female
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 280 S 79TH ST #1402
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City | WEST DES MOINES
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State | IA
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Zip | 50266-8086
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Country | US
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Telephone | 515-256-0323
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Fax | 515-537-1051
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Provider Business Mailing Address
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Address Line | PO BOX 66054
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City | WEST DES MOINES
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State | IA
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Zip | 50266
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Country | US
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Telephone | 515-256-0323
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Fax | 515-537-1051
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 00374
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 00374
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License Number State | IA
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