Individual
MR. JOHN R. CHURCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
847 W 4TH ST, WATERLOO, IA 50702-2141
(319) 215-8197
Mailing address
4002 MATTHEW DR, WATERLOO, IA 50701-3563
(319) 215-8197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001065
IA
Other
Enumeration date
09/07/2009
Last updated
09/19/2018
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