| NPI | 1942633417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL M LIGHTCAP Principle, Practitioner 563-583-5627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IA 00716) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2013-08-19 |