Individual
MANDI DOLIESLAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
400 CENTRAL AVE NW STE 300, ORANGE CITY, IA 51041-1332
(712) 737-2635
(712) 737-2344
Mailing address
400 CENTRAL AVE NW STE 300, ORANGE CITY, IA 51041-1332
(712) 737-2635
(712) 737-2344
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
086471
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086471
LCSW LICENSE NUMBER
IA
Enumeration date
06/26/2017
Last updated
07/21/2022
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