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Individual

JEREMY DAVID EASTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
TLMHC

Contact information

Practice address
227 E SAN MARNAN DR, WATERLOO, IA 50702-5829
(800) 531-4236
Mailing address
PO BOX 233, GRUNDY CENTER, IA 50638-0233

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
123981
IA
101YM0800X
Mental Health Counselor
Primary
123981
IA
101YP2500X
Professional Counselor
123981
IA

Other

Enumeration date
03/04/2024
Last updated
03/07/2024
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