Organization
EAST IOWA PSYCHOLOGY GROUP PC
Active
Other names
Eastdale Psychology Group PC
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE M GREEN PHD (COOWNER)
(319) 358-9397
Entity
Organization
Contact information
Practice address
325 EAST WASHINGTON ST, STE 206, IOWA CITY, IA 52240
(319) 358-9397
(319) 354-9626
Mailing address
325 EAST WASHINGTON ST, STE 206, IOWA CITY, IA 52240
(319) 358-9397
(319) 354-9626
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54264
WELLMARK
IA
Enumeration date
04/13/2006
Last updated
11/29/2012
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