Individual
MS. THERESA R HEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
208 BANK ST, KEOKUK, IA 52632-5819
(319) 524-3876
Mailing address
2444 270TH ST, MONTROSE, IA 52639-9564
(319) 463-7774
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
04524
IA
1041C0700X
Clinical Social Worker
Primary
04524
IA
373H00000X
Day Training/Habilitation Specialist
024077
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024077
—
IA
01
—
04524
DEPT PROF REG
IA
01
—
370984175
BWAY ORG FEIN
—
Enumeration date
04/06/2007
Last updated
04/14/2009
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