Individual
JENNY C MCINTIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
740 N 15TH AVE, STE A, HIAWATHA, IA 52233-2384
(319) 398-3562
Mailing address
7234 HAMPSHIRE DR NE, CEDAR RAPIDS, IA 52402-6904
(319) 361-5462
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
072841
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074575
—
IA
Enumeration date
08/26/2015
Last updated
07/09/2021
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