Provider Demographics
NPI:1700033602
Name:GUZMAN, KAMI LYNN (MS)
Entity Type:Individual
Prefix:
First Name:KAMI
Middle Name:LYNN
Last Name:GUZMAN
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 1:300 W BROADWAY STE 107
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-4489
Mailing Address - Country:US
Mailing Address - Phone:712-328-3700
Mailing Address - Fax:
Practice Address - Street 1:300 W BROADWAY STE 107
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4489
Practice Address - Country:US
Practice Address - Phone:712-328-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001148101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor