Individual
BRENDA J HANAFAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
136 S 7TH ST, COUNCIL BLUFFS, IA 51501-4133
(712) 325-1136
(712) 325-1152
Mailing address
609 SPENCER AVE, COUNCIL BLUFFS, IA 51503-0424
(712) 322-8127
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05574
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236010
MIDLANDS CHOICE
IA
01
—
39717
WELLMARK
IA
Enumeration date
02/10/2006
Last updated
07/08/2007
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