Individual
JORGE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
(319) 423-0919
Mailing address
4403 1ST AVE SE STE 104, CEDAR RAPIDS, IA 52402-3221
(319) 423-0919
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1370
IA
Other
Enumeration date
04/21/2014
Last updated
04/21/2014
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