Basic Information
| Provider Information | |||||||||
| NPI: | 1740244359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OUDHEUSDEN DALPEZ | ||||||||
| FirstName: | KRIEMHILD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LISW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | OUDHEUSDEN | ||||||||
| OtherFirstName: | KRIEMHILD | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | LISW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 625 COURT ST. | ||||||||
| Address2: | |||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511011919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122523871 | ||||||||
| FaxNumber: | 7122523157 | ||||||||
| Practice Location | |||||||||
| Address1: | 625 COURT ST. | ||||||||
| Address2: | SIOUXLAND MENTAL HEALTH CENTER | ||||||||
| City: | SIOUX CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 511011919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7122523871 | ||||||||
| FaxNumber: | 7122221438 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 11/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 01122 | IA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | IA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.