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Organization
SANDY MAE GANNON COMPANY PLC
Active
Organization
SANDY MAE GANNON COMPANY PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA MAE GANNON LISW, ACSW (PRESIDENT)
(319) 621-5416
Entity
Organization
Contact information
Practice address
103 S MAIN ST, NORTH ENGLISH, IA 52316-9504
(319) 664-3333
Mailing address
3217 RAVEN ST, IOWA CITY, IA 52245-5129
(319) 621-5416
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
00590
IA
Other
Enumeration date
08/22/2016
Last updated
11/01/2016
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