Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 00471 | IA |
NPI | 1003139528 |
---|---|
Provider Name | Denise Zmolek |
First Address | Cedar Rapids, IA 52405-3811 |
Second Address | Cedar Rapids, IA 52405-3811 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2010 |
Last Update Date | 11/03/2010 |