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General NPI Number Information
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NPI Number | 1255912457
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Entity Type | Organization
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Legal Business Name | MELANIE RAINBOW THERAPIST LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 520 E WASHINGTON ST STE 1
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City | IOWA CITY
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State | IA
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Zip | 52240-1831
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Country | US
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Telephone | 319-383-0039
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Fax |
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Provider Business Mailing Address
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Address Line | 3364 S JAMIE LN
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City | IOWA CITY
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State | IA
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Zip | 52240-3087
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MELANIE RAINBOW-HAREL
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Credential |
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Telephone | 319-383-0039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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