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General NPI Number Information
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NPI Number | 1760169502
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Entity Type | Organization
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Legal Business Name | REDWOOD THERAPY DSM PLLC
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 2700 WESTOWN PKWY STE 425
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1434
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Country | US
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Telephone | 515-259-0706
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 WESTOWN PKWY STE 425
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1434
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Country | US
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Telephone | 515-259-0706
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL PETER GREENBERG
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Credential | PSYD
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Telephone | 510-393-8350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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