| NPI | 1427112440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN R. EDWARDS Owner 319-277-4383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 00960) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IA 06148) |
| 101YM0800X Counselor, Mental Health (Licence: IA 00005) | |
| 106H00000X Marriage & Family Therapist (Licence: IA 00001) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |