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General NPI Number Information
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NPI Number | 1871783548
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Entity Type | Individual
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Provider Name | DEREK THOMAS HESS J.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 06/13/2023
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Provider Practice Location Address
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Address Line | 321 E 12TH ST
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City | DES MOINES
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State | IA
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Zip | 50319-1002
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Country | US
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Telephone | 518-929-2883
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Fax |
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Provider Business Mailing Address
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Address Line | 1436 41ST PL
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City | DES MOINES
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State | IA
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Zip | 50311-2524
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Country | US
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Telephone | 518-929-2883
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 094288
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License Number State | IA
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