Individual
MRS. NICHOLE SUE HENSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 VINE ST, WEST DES MOINES, IA 50265-4472
(515) 414-8049
Mailing address
1211 VINE ST, WEST DES MOINES, IA 50265-4472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T16077
—
IA
Enumeration date
11/13/2017
Last updated
11/16/2017
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