Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 04893 | IA |
NPI | 1003103169 |
---|---|
Provider Name | Ms. Amy Marie Hammerstrom |
First Address | Sioux City, IA 51104-3725 |
Second Address | Sioux City, IA 51104-3725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2011 |
Last Update Date | 14/02/2017 |