Individual
CHRISTINE MARIE VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
757 W BENTON ST, IOWA CITY, IA 52246-5953
(319) 339-4757
Mailing address
369 E COLLEGE ST, IOWA CITY, IA 52240-1690
(319) 339-4757
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
03057
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39249
BCBS PROVIDER #
IA
Enumeration date
09/17/2006
Last updated
09/10/2019
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