Individual
MARY LORD WOOLSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
209 EAST WASHINGTON STREET, SUITE 202, IOWA CITY, IA 52240-3928
(319) 354-3232
(319) 354-2990
Mailing address
209 EAST WASHINGTON STREET, SUITE 202, IOWA CITY, IA 52240-3928
(319) 354-3232
(319) 354-2990
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00850
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49617
BCBS IA
IA
Enumeration date
09/29/2006
Last updated
07/08/2007
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