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General NPI Number Information
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NPI Number | 1700471505
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Entity Type | Organization
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Legal Business Name | CHOICES THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 03/03/2021
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 3805 LOWER BEAVER RD
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City | DES MOINES
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State | IA
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Zip | 50310-4708
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Country | US
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Telephone | 515-279-0111
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Fax | 515-987-2390
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Provider Business Mailing Address
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Address Line | 2829 BUENA VISTA DR
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City | CLIVE
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State | IA
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Zip | 50325-4653
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Country | US
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Telephone | 515-279-0111
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Fax | 515-987-2390
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA L WOOD-CLARK
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Credential | MS
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Telephone | 515-279-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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