Individual
AMY J NISSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
1820 CENTRAL AVE, ESTHERVILLE, IA 51334-2409
(800) 592-0180
(712) 566-5229
Mailing address
PO BOX 36, ESTHERVILLE, IA 51334-0036
(800) 592-0180
(712) 566-5229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20087
IA
Other
Enumeration date
04/26/2022
Last updated
04/26/2022
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