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1760096184
EMA BASIE ENRIQUEZ
SPENCER, IA
NPI
1760096184
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IA t20047)
Enumeration Date
2020-09-02
Last Update Date
2020-09-02
Business Address
EMA BASIE ENRIQUEZ tCADC
201 E 11TH ST
SPENCER, IA 51301-4460
Phone number: 800-242-5101
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Mailing Address
EMA BASIE ENRIQUEZ tCADC
5073 370TH ST
CYLINDER, IA 50528-8017
Phone number: 712-298-4284
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