MEDICARE: HEATHER LUJANO LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	077993	IA

General Provider Information

NPI Number	:	1780042341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LUJANO LMSW

Provider Business Mailing Address
First Line	:	2005 ASBURY RD
Second Line	:
City	:	DUBUQUE
State	:	IA
Zip	:	52001-3042
Country	:	US
Telephone Number	:	563-583-7357
Fax Number	:	888-243-3455

Provider Business Practice Location Address
First Line	:	106 N JACKSON ST
Second Line	:
City	:	MT PLEASANT
State	:	IA
Zip	:	52641-2047
Country	:	US
Telephone Number	:	319-385-7177
Fax Number	:	319-385-9567

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2016
Last Update Date	:	02/10/2016

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