Doctor Name: | LYNNE A VESTAL |
NPI Number: | 1225162571 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | 00815 |
Business Practice Address: | 1239 73rd Street Suite J Windsor Heights, IA - 50311 |
Business Phone Number: | 5152678899 |
Business Fax Number: | 5152235572 |
Mailing Address: | 1239 73rd Street, Suite J WINDSOR HEIGHTS |
State: | IA |
Postal Code: | 50311 |
Phone Number: | 5152678899 |
Fax Number: | 5152235572 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 00815 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |