Organization
COURAGEOUS AIM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA MARIE CAROTHERS LISW (OWNER/PROVIDER)
(563) 505-0141
Entity
Organization
Contact information
Practice address
2805 EASTERN AVE STE D, DAVENPORT, IA 52803-2074
(563) 505-0141
Mailing address
2805 EASTERN AVE STE D, DAVENPORT, IA 52803-2074
(563) 505-0141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074526
—
IA
Enumeration date
09/12/2022
Last updated
09/28/2022
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