Individual
STACI LYNN FOSENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3509 E 29TH ST, DES MOINES, IA 50317-4253
(515) 248-1600
(515) 248-1610
Mailing address
1200 UNIVERSITY AVE STE 200, DES MOINES, IA 50314-2355
(515) 248-1447
(515) 248-1440
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IA
Other
Enumeration date
06/23/2017
Last updated
09/11/2025
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