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General NPI Number Information
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NPI Number | 1720873987
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Entity Type | Individual
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Provider Name | TYLAIAH SAULSBERRY LMSW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2025
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 4309 UNIVERSITY AVE
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City | DES MOINES
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State | IA
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Zip | 50311-3423
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Country | US
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Telephone | 515-996-5935
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Fax | 515-414-7638
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Provider Business Mailing Address
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Address Line | 5125 NE 23RD AVE UNIT 3311
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City | PLEASANT HILL
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State | IA
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Zip | 50327-7033
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Country | US
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Telephone | 515-339-6291
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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 | 128757
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License Number State | IA
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