JACK FORMANEK

COUNCIL BLUFFS, IA
NPI1285791376
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: IA  205)
Enumeration Date2007-01-02
Last Update Date2007-07-08
Business Address
-- JACK FORMANEK MS, LMHP
307 E VIEW DR
COUNCIL BLUFFS, IA 51503-0464
Phone number: 712-325-1584
Mailing Address
-- JACK FORMANEK MS, LMHP
307 E VIEW DR
COUNCIL BLUFFS, IA 51503-0464
Phone number: 712-325-1584
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