| Kimberly Anne Conrad Plc | |
|
100 1st Ave Sw Waucoma IA 52171-9705 | |
| (563) 776-4060 | |
| (563) 776-4061 |
| Full Name | Kimberly Anne Conrad Plc |
|---|---|
| Speciality | Counselor - School |
| Location | 100 1st Ave Sw, Waucoma, Iowa |
| Authorized Official Name and Position | Kimberly Anne Conrad (DIRECTOR) |
| Authorized Official Contact | 3192400944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Anne Conrad Plc 25271 Johnsons Mill Rd Waucoma IA 52171-7137 Ph: (219) 240-0944 | Kimberly Anne Conrad Plc 100 1st Ave Sw Waucoma IA 52171-9705 Ph: (563) 776-4060 |
| NPI Number | 1932286085 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/25/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932286085 | NPI | - | NPPES |
| 0470138 | Medicaid | IA | |
| 1012617 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YS0200X | Counselor - School | 351029 (Iowa) | Primary |
| 251S00000X | Community/behavioral Health | 06449 (Iowa) | Secondary |
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