| Psychology Iowa | |
|
3703 Douglas Ave Des Moines IA 50310-5347 | |
| (515) 277-4357 | |
| Not Available |
| Full Name | Psychology Iowa |
|---|---|
| Speciality | Psychologist |
| Location | 3703 Douglas Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Jeffrey Scott Kinderdietz (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5152774357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychology Iowa 3703 Douglas Ave Des Moines IA 50310-5347 Ph: (515) 277-4357 | Psychology Iowa 3703 Douglas Ave Des Moines IA 50310-5347 Ph: (515) 277-4357 |
| NPI Number | 1245889104 |
|---|---|
| Provider Enumeration Date | 09/04/2019 |
| Last Update Date | 10/08/2019 |
| Medicare PECOS PAC ID | 4688905219 |
|---|---|
| Medicare Enrollment ID | O20191014001634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245889104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jeffrey Scott Kinderdietz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730518614 PECOS PAC ID: 5597096123 Enrollment ID: I20200717001974 |
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