Individual
KIMBERLY ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2750 SAINT FRANCIS DR, WATERLOO, IA 50702-5644
(319) 272-8922
(319) 272-8929
Mailing address
2750 SAINT FRANCIS DR, WATERLOO, IA 50702-5644
(192) 728-9223
(319) 272-8929
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
001318
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074575
—
IA
Enumeration date
07/27/2010
Last updated
11/22/2021
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