Provider Demographics
NPI:1487054359
Name:KLYNSMA, AMBER (LMSW, TCADC, P-CFLE)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KLYNSMA
Suffix:
Gender:F
Credentials:LMSW, TCADC, P-CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 384
Mailing Address - Street 2:
Mailing Address - City:HOSPERS
Mailing Address - State:IA
Mailing Address - Zip Code:51238-0384
Mailing Address - Country:US
Mailing Address - Phone:800-242-5101
Mailing Address - Fax:
Practice Address - Street 1:201 E 11TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4436
Practice Address - Country:US
Practice Address - Phone:800-242-5101
Practice Address - Fax:712-264-9399
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-28
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker