Provider Demographics
NPI:1063486330
Name:IHNS, JESSICA A (PSYD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:IHNS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:SCHMIDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:229 S MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-3056
Mailing Address - Country:US
Mailing Address - Phone:563-552-7080
Mailing Address - Fax:800-394-1580
Practice Address - Street 1:229 S MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-3056
Practice Address - Country:US
Practice Address - Phone:563-552-7080
Practice Address - Fax:800-394-1580
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00999103TC0700X, 101YM0800X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health