Individual
GREG FUQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
1105 N ANKENY BLVD STE 100, ANKENY, IA 50023-4003
(515) 255-8399
Mailing address
600 42ND ST, DES MOINES, IA 50312-2701
(515) 255-8399
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99672
IA
Other
Enumeration date
06/17/2020
Last updated
09/26/2023
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