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General NPI Number Information
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NPI Number | 1942702410
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Entity Type | Organization
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Legal Business Name | NELSON-KIRBY THERAPY & CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 03/01/2018
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Last Update Date | 03/01/2018
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Provider Practice Location Address
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Address Line | 3900 INGERSOLL AVENUE SUITE 108
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City | DES MOINES
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State | IA
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Zip | 50312
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Country | US
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Telephone | 515-988-1027
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 INGERSOLL AVENUE SUITE 108
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City | DES MOINES
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State | IA
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Zip | 50312
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Country | US
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Telephone | 515-988-1027
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Fax |
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Authorized Official
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Title or Position | THERAPIST/CLINICAL SUPERVISOR/CEO
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Name | JAMIE LYNN NELSON-KIRBY
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Credential | MA, LMFT
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Telephone | 515-988-1027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000328
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License Number State | IA
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