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General NPI Number Information
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NPI Number | 1437201258
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Entity Type | Individual
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Provider Name | JOAN SUMMERS WILLHOIT LISW
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Gender | Female
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 102 N HANCOCK ST
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City | OTTUMWA
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State | IA
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Zip | 52501-4648
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Country | US
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Telephone | 641-683-1302
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Fax | 641-683-1309
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Provider Business Mailing Address
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Address Line | 3029 BLADENSBURG RD
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City | BATAVIA
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State | IA
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Zip | 52533-8615
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Country | US
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Telephone | 641-934-5347
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 00854
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License Number State | IA
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