Provider Demographics
NPI:1396425880
Name:GJERDE-KEMPF, KARI KRISTINA (PHD, BCBA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:KRISTINA
Last Name:GJERDE-KEMPF
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 CURTIS BRIDGE RD NE
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9590
Mailing Address - Country:US
Mailing Address - Phone:319-325-1988
Mailing Address - Fax:
Practice Address - Street 1:320 W CHERRY ST
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8819
Practice Address - Country:US
Practice Address - Phone:319-626-3300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA110897103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist