Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | IA |
NPI | 1003483009 |
---|---|
Provider Name | Lillian Buschette |
First Address | Des Moines, IA 50314-2329 |
Second Address | Des Moines, IA 50316-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2021 |
Last Update Date | 08/06/2021 |