# INNOVATIVE FAMILY THERAPY & PLAY THERAPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497219653
- **Authorized official:** THERESA RECKLING MA, LMFT, RPT (OWNER/LMFT)
- **Authorized official phone:** (319) 759-9414

## Contact information

- **Practice address:** 409 N 4TH ST STE 108, BURLINGTON, IA 52601-5255
- **Practice address phone:** (319) 759-9414
- **Mailing address:** PO BOX 12, BURLINGTON, IA 52601-0012
- **Mailing address phone:** (319) 759-9414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2019
- **Last updated:** 01/22/2019