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General NPI Number Information
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NPI Number | 1699071589
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Entity Type | Individual
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Provider Name | JENNIFER E KASSING M.A., PLMHP
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Gender | Female
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 02/10/2011
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Provider Practice Location Address
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Address Line | 1000 W 29TH ST SUITE 319
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City | SOUTH SIOUX CITY
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State | NE
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Zip | 68776-3852
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Country | US
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Telephone | 402-494-4904
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Fax |
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Provider Business Mailing Address
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Address Line | 1915 JACKSON ST
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City | SIOUX CITY
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State | IA
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Zip | 51104-3430
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Country | US
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Telephone | 402-404-1036
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9331
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License Number State | NE
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