Individual
LAURA ASHLEY BODDICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CRC
Contact information
Practice address
1221 CENTER POINT RD NE, CEDAR RAPIDS, IA 52402-6571
(319) 378-1199
(319) 378-7497
Mailing address
1221 CENTER POINT RD NE, CEDAR RAPIDS, IA 52402-6571
(319) 378-1199
(319) 378-7497
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
083691
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740279355
FAMILY PSYCHOLOGY
IA
Enumeration date
09/02/2016
Last updated
09/02/2016
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