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Individual

LORRA REA GIRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
110 E MAIN ST, OTTUMWA, IA 52501-2910
(641) 682-8772
(641) 682-1924
Mailing address
110 E MAIN ST, OTTUMWA, IA 52501-2910
(641) 682-8772
(641) 682-1924

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
007855
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1659353670
BC/BS
IA
05
1659359670
IA
Enumeration date
06/28/2012
Last updated
06/28/2012
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