Organization
THE WILLOW GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY Y LARSEN PH.D. (DIRECTOR)
(712) 323-1728
Entity
Organization
Contact information
Practice address
601 WILLOW AVE, COUNCIL BLUFFS, IA 51501-4242
(712) 323-1728
(712) 323-8888
Mailing address
601 WILLOW AVE, COUNCIL BLUFFS, IA 51501-4242
(712) 323-1728
(712) 323-8888
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
116
IA
Other
Enumeration date
03/19/2007
Last updated
08/22/2020
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