Individual
TABITHA JUNE NORGAARD NICOLAYSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5415 NW 88TH ST, SUITE 100, JOHNSTON, IA 50131-2950
(515) 727-1338
Mailing address
5415 NW 88TH ST, SUITE 100, JOHNSTON, IA 50131-2950
(206) 933-7095
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
085270
IA
Other
Enumeration date
09/24/2012
Last updated
01/16/2017
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