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Individual

MYLEENA R GRENIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
200 HAWKINS DR, C124 GH, IOWA CITY, IA 52242-1009
(319) 356-1917
Mailing address
200 HAWKINS DR, C124 GH, IOWA CITY, IA 52242-1009
(319) 356-1917

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12057
IA
104100000X
Social Worker
007427
IA
1041C0700X
Clinical Social Worker
Primary
007427
IA

Other

Enumeration date
02/04/2014
Last updated
01/03/2019
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