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1073291902
CLARISSA ROSALEE JOLLY
WATERLOO, IA
NPI
1073291902
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA 23055)
Enumeration Date
2023-07-10
Last Update Date
2023-07-10
Business Address
CLARISSA ROSALEE JOLLY tCADC
3640 CANTERBURY CT
WATERLOO, IA 50702-5705
Phone number: 319-252-4631
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Mailing Address
CLARISSA ROSALEE JOLLY tCADC
3640 CANTERBURY CT
WATERLOO, IA 50702-5705
Phone number: 319-252-4631
Copy
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