| NPI | 1760617138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ALAN GREGORY Owner 319-464-2940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 00975) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-05-28 |