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General NPI Number Information
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NPI Number | 1265973796
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Entity Type | Individual
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Provider Name | CHRISTINA SOWERS
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Gender | Female
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 520 10TH AVE STE B37
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City | CORALVILLE
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State | IA
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Zip | 52241-1910
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Country | US
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Telephone | 319-688-3402
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Fax |
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Provider Business Mailing Address
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Address Line | 2526 NEVADA AVE
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City | IOWA CITY
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State | IA
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Zip | 52240-6756
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 11113
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 001374
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License Number State | IA
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