| NPI | 1194819128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA S LARSEN Business Manager 319-865-3027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 00846) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 00187) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |