Provider Demographics
NPI:1104151471
Name:BRENNSCHEIDT, KARLA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:
Last Name:BRENNSCHEIDT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 FRANKLIN ST
Mailing Address - Street 2:STE A-2
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2746
Mailing Address - Country:US
Mailing Address - Phone:319-273-8049
Mailing Address - Fax:319-273-8054
Practice Address - Street 1:209 FRANKLIN ST
Practice Address - Street 2:STE A-2
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2746
Practice Address - Country:US
Practice Address - Phone:319-273-8049
Practice Address - Fax:319-273-8054
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1224103G00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation