Healthcare Provider Details

I. General information

NPI: 1669133575
Provider Name (Legal Business Name): DOZIER THERAPY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 42ND ST NE STE R
CEDAR RAPIDS IA
52402-3066
US

IV. Provider business mailing address

1660 42ND ST NE STE R
CEDAR RAPIDS IA
52402-3066
US

V. Phone/Fax

Practice location:
  • Phone: 319-213-7478
  • Fax: 319-289-7017
Mailing address:
  • Phone: 319-213-7478
  • Fax: 319-289-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1245411339
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: MR. DENNIS L DOZIER
Title or Position: OWNER
Credential: LISW
Phone: 844-451-8255