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Individual

ALEXANDRA JENNETTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
558 28TH ST, DES MOINES, IA 50312-5222
(515) 218-9182
Mailing address
4007 LINCOLN PLACE DR, DES MOINES, IA 50312-3051
(515) 556-5558

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
T23002
IA
101YM0800X
Mental Health Counselor
Primary
117779
IA

Other

Enumeration date
03/15/2023
Last updated
03/15/2023
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