Individual
DIANE MCDONALD-GOETZMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW
Contact information
Practice address
3501 HARRY LANGDON BLVD, CHILD HEALTH SPECIALTY CLINICS, COUNCIL BLUFFS, IA 51503-7837
(712) 309-0041
(712) 309-0044
Mailing address
3501 HARRY LANGDON BLVD, CHILD HEALTH SPECIALTY CLINICS, COUNCIL BLUFFS, IA 51503-7837
(712) 309-0041
(712) 309-0044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
02831
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01055
WELLMARK BCBS
IA
Enumeration date
03/19/2007
Last updated
10/01/2007
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