Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 00933 | IA |
NPI | 1003002114 |
---|---|
Provider Name | Barbara Jean Patschke |
First Address | Cedar Rapids, IA 52406-0337 |
Second Address | Cedar Rapids, IA 52402-5057 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2007 |
Last Update Date | 27/11/2007 |