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Individual

LEA SIEREN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LISW

Contact information

Practice address
1112 N VAN BUREN AVE, OTTUMWA, IA 52501-6416
(641) 684-7744
Mailing address
1112 N VAN BUREN AVE, OTTUMWA, IA 52501-6416
(641) 684-7744

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
00831
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11698
INDIVIDUAL PROVIDER #
IA
01
260048928
INDIIDUAL PROVIDER #
IA
05
2776088
IA
01
421525352-02
INDIVIDUAL PROVIDER #
IA
01
43609
INDIVIDUAL PROVIDER #
IA
Enumeration date
09/14/2006
Last updated
07/09/2007
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