Organization
JENNIFER L. STREETS GLADWIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. STREETS GLADWIN LCPC, LMHC (OWNER)
(309) 507-1791
Entity
Organization
Contact information
Practice address
3481 UTICA RIDGE RD, BETTENDORF, IA 52722-1617
(309) 507-1791
Mailing address
3481 UTICA RIDGE RD, BETTENDORF, IA 52722-1617
(309) 507-1791
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001200
IA
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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