MEDICARE: DAISY HATCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	118488	IA

General Provider Information

NPI Number	:	1699550459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAISY HATCH

Provider Business Mailing Address
First Line	:	330 NW HORAN CT
Second Line	:
City	:	WAUKEE
State	:	IA
Zip	:	50263-2901
Country	:	US
Telephone Number	:	319-239-5903
Fax Number	:

Provider Business Practice Location Address
First Line	:	4800 AURORA AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50310-2903
Country	:	US
Telephone Number	:	319-239-5903
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	05/28/2026

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Directions to “ DAISY HATCH ” Practice Location

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