Organization
WILLOW GROVE THERAPY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANN WATERHOUSE PHD (PSYCHOLOGIST)
(515) 631-0454
Entity
Organization
Contact information
Practice address
9105 NORTHPARK DR, JOHNSTON, IA 50131-4807
(515) 984-0225
(515) 984-0226
Mailing address
9105 NORTHPARK DR, JOHNSTON, IA 50131-4807
(515) 984-0225
(515) 984-0226
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
03/05/2018
Last updated
11/25/2024
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