Organization
MID-IOWA FAMILY THERAPY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE ANN SECRIST L.M.F.T. (ADMINISTRATOR)
(515) 465-5739
Entity
Organization
Contact information
Practice address
410 12TH ST, PERRY, IA 50220-7586
(515) 465-5739
(515) 465-5744
Mailing address
PO BOX 416, PERRY, IA 50220-0416
(515) 465-5739
(515) 465-5744
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0467035
—
IA
Enumeration date
10/24/2006
Last updated
04/27/2012
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