Provider Demographics
NPI:1871817239
Name:ESPY, KALEN JO
Entity Type:Individual
Prefix:
First Name:KALEN
Middle Name:JO
Last Name:ESPY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2533 SCOTT BLVD SE
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-8195
Mailing Address - Country:US
Mailing Address - Phone:319-338-9212
Mailing Address - Fax:
Practice Address - Street 1:2533 SCOTT BLVD SE
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-8195
Practice Address - Country:US
Practice Address - Phone:319-338-9212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001278101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health