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General NPI Number Information
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NPI Number | 1053126110
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Entity Type | Organization
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Legal Business Name | WILLOW TREE HOLISTIC HEALTH
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 2927 IWV ROAD SW
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City | IOWA CITY
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State | IA
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Zip | 52246
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Country | US
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Telephone | 319-281-0290
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Fax | 319-500-4642
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Provider Business Mailing Address
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Address Line | 450 HIGHWAY 1 W STE 176
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City | IOWA CITY
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State | IA
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Zip | 52246-4204
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Country | US
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Telephone | 319-281-0290
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Fax | 319-500-4642
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Authorized Official
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Title or Position | ARNP, PMHNP-BC
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Name | JAMI LORRAINE WITBECK
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Credential | ARNP
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Telephone | 563-260-7223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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