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Individual

AMANDA LE LARKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
110 E MAIN ST, OTTUMWA, IA 52501-2910
(641) 682-8772
Mailing address
110 E MAIN ST, OTTUMWA, IA 52501-2910
(641) 682-8772

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
05847
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0298372
IA
01
220784
IOWA HEALTH SOLUTIONS
IA
01
I022
TRIWEST
IA
01
P00043190
RAILROAD MEDICARE
IA
Enumeration date
08/30/2005
Last updated
05/26/2016
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