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Provider Information for 1740775568


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MELISSA REYERSON-SLIFER LMSW


Sex: Female

NPI: 1740775568
Last Updated: 2018-06-25
Certification Date:

Details

NameValue
NPI1740775568
Enumeration Date2018-06-25
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 3215 WOLCOTT AVE
DES MOINES, IA 50321-1947
United States

Phone: 515-829-7735 | Fax:
 
Primary Practice Address 918 SE 11TH ST
DES MOINES, IA 50309-5324
United States

Phone: 515-282-9377 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 104100000X - Social Worker IA090798