Healthcare Provider Details

I. General information

NPI: 1255259081
Provider Name (Legal Business Name): RENAY MARIE CABBAGE TLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 W DIVISION ST
CLARINDA IA
51632-2509
US

IV. Provider business mailing address

216 W DIVISION ST
CLARINDA IA
51632-2509
US

V. Phone/Fax

Practice location:
  • Phone: 712-548-2388
  • Fax: 712-542-2984
Mailing address:
  • Phone: 712-548-2388
  • Fax: 712-542-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number132377
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: