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General NPI Number Information
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NPI Number | 1285920850
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Entity Type | Individual
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Provider Name | CHRISTINE MARIE FLATHERS LISW
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Gender | Female
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 125 S 3RD ST
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City | AMES
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State | IA
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Zip | 50010-7042
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Country | US
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Telephone | 515-233-2250
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Fax | 515-233-3235
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Provider Business Mailing Address
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Address Line | 420 KELLOGG AVE
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City | AMES
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State | IA
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Zip | 50010-6226
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Country | US
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Telephone | 515-233-3141
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Fax | 515-233-2440
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 2010039053
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 008070
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License Number State | IA
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