Ivory Lotus Therapy
Counselor, Mental Health in Waukee, IA. Organization (NPI-2).
NPI number1487370433
StatusActive
Last updated in NPPESMar 27, 2023
Details
- NPI
- 1487370433
- Entity type
- Organization (NPI-2)
- Legal business name
- Ivory Lotus Therapy
- Organization subpart
- No
- Enumeration date
- Oct 12, 2022
- Certification date
- Mar 27, 2023
- Last updated
- Mar 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
225 Ne Dartmoor Dr Ste 300Waukee, IA 50263-9665
Phone 515-650-2454
Mailing address
225 Ne Dartmoor Dr Ste 300Waukee, IA 50263-9665
Phone 515-650-2454
Authorized official
Jasmina Pajazetovic
Clinical Therapist
5156502454
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