Individual
MS. MARY E MIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
105 S MARSHALL ST, BOONE, IA 50036-4899
(515) 432-7983
(515) 432-7657
Mailing address
105 S MARSHALL ST, BOONE, IA 50036-4899
(515) 432-7983
(515) 432-7657
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00780
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015180
—
IA
Enumeration date
08/14/2008
Last updated
09/25/2009
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