Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 006933 | IA |
NPI | 1003051376 |
---|---|
Provider Name | Christopher M Loeckle |
First Address | Iowa City, IA 52240-6259 |
Second Address | Iowa City, IA 52240-1759 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2008 |
Last Update Date | 31/01/2014 |