| NPI | 1699286427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZARA WANLASS Member, Practice Manager 319-804-9312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 7530) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 081108) |
| 1041C0700X Social Worker, Clinical (Licence: IA 007582) | |
| 1041C0700X Social Worker, Clinical (Licence: IA 06670) | |
| 106H00000X Marriage & Family Therapist (Licence: IA 000360) | |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2025-04-28 |