| Self Discoveries Plc | |
|
6165 Nw 86th St Johnston IA 50131-2270 | |
| (515) 978-1305 | |
| Not Available |
| Full Name | Self Discoveries Plc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6165 Nw 86th St, Johnston, Iowa |
| Authorized Official Name and Position | Derek Michael Potthoff (PROVIDER/OWNER) |
| Authorized Official Contact | 5159781305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Self Discoveries Plc 6165 Nw 86th St Johnston IA 50131-2270 Ph: (515) 978-1305 | Self Discoveries Plc 6165 Nw 86th St Johnston IA 50131-2270 Ph: (515) 978-1305 |
| NPI Number | 1063193761 |
|---|---|
| Provider Enumeration Date | 07/26/2023 |
| Last Update Date | 07/26/2023 |
| Certification Date | 07/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063193761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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