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General NPI Number Information
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NPI Number | 1861672917
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Entity Type | Organization
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Legal Business Name | THE O'ROURKE GROUP, PC
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Dates
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Enumeration Date | 11/06/2007
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 610 N 4TH ST SUITE 110A
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City | BURLINGTON
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State | IA
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Zip | 52601-5055
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Country | US
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Telephone | 319-754-8035
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Fax | 319-754-9213
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Provider Business Mailing Address
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Address Line | 610 N 4TH ST SUITE 110A
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City | BURLINGTON
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State | IA
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Zip | 52601-5055
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Country | US
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Telephone | 319-754-8035
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Fax | 319-754-9213
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Authorized Official
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Title or Position | OWNER / THERAPIST
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Name | PEG SUE O'ROURKE
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Credential | PH.D.
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Telephone | 319-754-8035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State | IA
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