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General NPI Number Information
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NPI Number | 1932083896
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Entity Type | Organization
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Legal Business Name | JENNIFER GAGE LMFT LLLC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 118 3RD AVE SE STE 311
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City | CEDAR RAPIDS
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State | IA
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Zip | 52401-1408
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Country | US
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Telephone | 319-775-0007
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Fax |
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Provider Business Mailing Address
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Address Line | 118 3RD AVE SE STE 311
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City | CEDAR RAPIDS
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State | IA
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Zip | 52401-1408
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Country | US
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Telephone | 319-775-0007
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | JENNIFER GAGE
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Credential |
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Telephone | 319-775-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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