| Kathryn E. Wierda, Ph.d., Pllc | |
|
1045 76th St Unit 3030 West Des Moines IA 50266 | |
| (515) 777-3388 | |
| (515) 777-3387 |
| Full Name | Kathryn E. Wierda, Ph.d., Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1045 76th St Unit 3030, West Des Moines, Iowa |
| Authorized Official Name and Position | Kathryn Wierda (OWNER) |
| Authorized Official Contact | 5157773388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathryn E. Wierda, Ph.d., Pllc 1045 76th St Unit 3030 West Des Moines IA 50266-5913 Ph: (515) 777-3388 | Kathryn E. Wierda, Ph.d., Pllc 1045 76th St Unit 3030 West Des Moines IA 50266 Ph: (515) 777-3388 |
| NPI Number | 1427554443 |
|---|---|
| Provider Enumeration Date | 03/30/2018 |
| Last Update Date | 05/21/2018 |
| Medicare PECOS PAC ID | 8729330626 |
|---|---|
| Medicare Enrollment ID | O20181003002821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427554443 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 084157 (Iowa) | Primary |
| Provider Name | Kathryn Elizabeth Wierda |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346746369 PECOS PAC ID: 0547512444 Enrollment ID: I20181003003040 |
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