| Katherine L. Nydam Olivier, Lisw Llc | |
|
757 W Benton St Iowa City IA 52246-5953 | |
| (319) 339-4757 | |
| Not Available |
| Full Name | Katherine L. Nydam Olivier, Lisw Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 757 W Benton St, Iowa City, Iowa |
| Authorized Official Name and Position | Katherine L Nydam Olivier (PRESIDENT) |
| Authorized Official Contact | 3193394757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine L. Nydam Olivier, Lisw Llc 757 W Benton St Iowa City IA 52246-5953 Ph: (319) 339-4757 | Katherine L. Nydam Olivier, Lisw Llc 757 W Benton St Iowa City IA 52246-5953 Ph: (319) 339-4757 |
| NPI Number | 1932613254 |
|---|---|
| Provider Enumeration Date | 11/22/2017 |
| Last Update Date | 11/22/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932613254 | NPI | - | NPPES |
| 1041CO700X | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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