Healthcare Provider Details

I. General information

NPI: 1922572551
Provider Name (Legal Business Name): JESSICA HOBART-COLLIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2019
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 US 6 W
IOWA CITY IA
52246
US

IV. Provider business mailing address

4377 E COURT ST
IOWA CITY IA
52245-9305
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-0581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number095222
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: