Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 10129 | IA |
Y | 101YM0800X | Mental Health Counselor | 074697 | IA |
NPI | 1003231143 |
---|---|
Provider Name | Jo Carthey |
First Address | Davenport, IA 52803-2107 |
Second Address | Davenport, IA 52803-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2014 |
Last Update Date | 26/01/2015 |