| NPI | 1053058891 |
|---|---|
| Other Name | TAMARA M. WIRTH, LLC |
| Entity Type | Organization |
| Authorized Contact | TAMARA M WIRTH Owern/Provider 515-337-2872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-05-13 |
| Last Update Date | 2022-05-13 |