Healthcare Provider Details

I. General information

NPI: 1174700835
Provider Name (Legal Business Name): COUNSELING CENTER FOR INDIVIDUAL & FAMILY DEVELOPMENT LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2008
Last Update Date: 09/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 NORTHGATE DR SUITE E
IOWA CITY IA
52245-9501
US

IV. Provider business mailing address

3030 NORTHGATE DR SUITE E
IOWA CITY IA
52245-9501
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-6483
  • Fax:
Mailing address:
  • Phone: 319-337-6483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. SANDY L MURPHY
Title or Position: OFFICE MANAGER
Credential:
Phone: 319-337-6483