Healthcare Provider Details

I. General information

NPI: 1679789614
Provider Name (Legal Business Name): ROBIN L. MOELLER-SUNDERMAN MSW, LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SOUTHWEST IOWA FAMILIES 215 E. WASHINGTON ST.
CLARINDA IA
51632
US

IV. Provider business mailing address

2575-160TH ST.
CLARINDA IA
51632-5023
US

V. Phone/Fax

Practice location:
  • Phone: 712-542-3501
  • Fax: 712-542-4725
Mailing address:
  • Phone: 712-542-4266
  • Fax: 712-542-4725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number01050
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: