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Individual

GLENNA R NOCKELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
311 S CLARK ST, CARROLL, IA 51401-3038
(712) 794-5435
(712) 792-5751
Mailing address
320 E ADAMS ST, LAKE CITY, IA 51449-1306
(515) 290-3550

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
007725
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007725
IOWA LICENSE
IA
Enumeration date
08/01/2011
Last updated
08/01/2011
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