Individual
JENNA FOURRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5005 BOWLING ST SW STE C, CEDAR RAPIDS, IA 52404-5070
(319) 531-3824
Mailing address
PO BOX 564, TIFFIN, IA 52340-0564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
18057
IA
Other
Enumeration date
10/01/2018
Last updated
10/01/2018
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