Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 06140 | IA |
NPI | 1003001520 |
---|---|
Provider Name | Mrs. Michelle Lynn Buethe |
First Address | Grimes, IA 50111-0000 |
Second Address | Grimes, IA 50111-0000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2007 |
Last Update Date | 07/09/2007 |