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General NPI Number Information
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NPI Number | 1912401803
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Entity Type | Organization
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Legal Business Name | EMOTIONAL HEALTH PARTNERS, LLC
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 615 GRANT AVE
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City | WATERLOO
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State | IA
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Zip | 50702-2111
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Country | US
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Telephone | 319-610-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 615 GRANT AVE
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City | WATERLOO
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State | IA
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Zip | 50702-2111
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Country | US
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Telephone | 319-435-8212
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MS. EMILY KATHARINE ALLAIRE
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Credential | LISW, CADC
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Telephone | 319-435-8212
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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 | 007059
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License Number State | IA
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