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Individual

DIANE J. BAUMBACH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
L.I.S.W

Contact information

Practice address
320 KIRKWOOD AVE, IOWA CITY, IA 52240-4754
(319) 351-6654
(319) 339-0905
Mailing address
320 KIRKWOOD AVE, IOWA CITY, IA 52240-4754
(319) 351-6654
(319) 339-0905

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00040
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01865
BLUE CROSS/BLUE SHIELD OF
IA
05
421501340Y1R3P8
IA
Enumeration date
07/21/2005
Last updated
07/08/2007
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