Individual
KIM ROBERTS BLAKEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IADC
Contact information
Practice address
1300 WOODLAND AVE, WEST DES MOINES, IA 50265-2306
(515) 280-3860
Mailing address
1300 WOODLAND AVE, WEST DES MOINES, IA 50265-2306
(515) 280-3860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13059
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177394
—
IA
01
—
68236
WELLMARK
IA
Enumeration date
11/16/2015
Last updated
04/28/2025
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