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NPI Code Detail

MEDICARE: OLIVIA OUTLUND LMSW

MEDICARE:   OLIVIA  OUTLUND  LMSW
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 Worker113223IA

General Provider Information

NPI Number : 1356050116
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA OUTLUND LMSW
Provider Business Mailing Address
First Line : 1483 WESTVIEW DR
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-1031
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 123 N LINN ST STE 2D
Second Line :
City : IOWA CITY
State : IA
Zip : 52245-2147
Country : US
Telephone Number : 319-224-5142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2022
Last Update Date : 11/21/2022

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Directions to “ OLIVIA OUTLUND LMSW” Practice Location

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