Provider Demographics
NPI:1255730909
Name:SPIESS, REBECCA (MS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SPIESS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6708 STAR VIEW ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-6508
Mailing Address - Country:US
Mailing Address - Phone:515-822-1269
Mailing Address - Fax:
Practice Address - Street 1:3811 38TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-3648
Practice Address - Country:US
Practice Address - Phone:515-401-6886
Practice Address - Fax:515-201-5237
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health