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Individual

MRS. TERRY JO CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CADC, LMHC

Contact information

Practice address
1642 42ND ST NE, CEDAR RAPIDS, IA 52402-3076
(319) 377-2161
(319) 377-2094
Mailing address
1642 42ND ST NE, CEDAR RAPIDS, IA 52402-3076
(319) 377-2161
(319) 377-2094

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
13071
IA
101YM0800X
Mental Health Counselor
Primary
001655
IA

Other

Enumeration date
08/27/2015
Last updated
08/31/2015
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