Individual
JILL HACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 5TH AVE, DES MOINES, IA 50309-1307
(515) 244-2267
Mailing address
808 5TH AVE, DES MOINES, IA 50309-1307
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2003030542
MO
103TC0700X
Clinical Psychologist
Primary
001131
IA
Other
Enumeration date
10/25/2006
Last updated
10/19/2015
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