| NPI | 1780119461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MCINNERNEY Owner/Therapist 515-556-9580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 072644) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 13009) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-09 |