Individual
LUCY MARILYN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, ATR-BC
Contact information
Practice address
2311 WARREN AVE, SAINT CHARLES, IA 50240-8502
(641) 396-2703
Mailing address
2311 WARREN AVE, SAINT CHARLES, IA 50240-8502
(641) 396-2703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00355
IA
Other
Enumeration date
04/07/2007
Last updated
07/08/2007
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