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NPI Code Detail

MEDICARE: KATHARINE JANIS GAROUTTE LISW

MEDICARE: KATHARINE JANIS GAROUTTE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker008001IA

General Provider Information

NPI Number : 1265079677
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE JANIS GAROUTTE LISW
Provider Business Mailing Address
First Line : 1225 E RIVER DR STE 330
Second Line :
City : DAVENPORT
State : IA
Zip : 52803-5761
Country : US
Telephone Number : 319-310-4772
Fax Number :
Provider Business Practice Location Address
First Line : 1225 E RIVER DR STE 330
Second Line :
City : DAVENPORT
State : IA
Zip : 52803-5761
Country : US
Telephone Number : 563-424-0136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2019
Last Update Date : 01/03/2024

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Directions to “ KATHARINE JANIS GAROUTTE LISW” Practice Location

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