Individual
MS. COLLEEN A MELLERUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1150 5TH ST, SUITE #267, CORALVILLE, IA 52241-2932
(319) 341-5933
Mailing address
1150 5TH ST, SUITE #267, CORALVILLE, IA 52241-2932
(319) 341-5933
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
995
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38484
WELLMARK BC/BS
IA
Enumeration date
07/11/2006
Last updated
08/04/2013
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