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Individual

KATHERINE JEAN VANBLAIR

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2102 E 38TH ST, DAVENPORT, HI 52807
(563) 359-4049
Mailing address
2102 E 38TH ST, DAVENPORT, HI 52807
(563) 359-4049

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT00166
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1108750000
IA
Enumeration date
03/22/2006
Last updated
07/08/2007
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