Individual
BETH KIELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TCADC
Contact information
Practice address
1221 PIERCE ST, SIOUX CITY, IA 51105-1418
(712) 255-0204
Mailing address
1221 PIERCE ST, SIOUX CITY, IA 51105-1418
(712) 255-0204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T22160
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010772181
—
IA
Enumeration date
01/20/2023
Last updated
01/20/2023
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