Individual
TAMMY LYNN WILGENBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-7999
(319) 384-7899
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 384-7999
(319) 384-7899
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
000463
IA
103T00000X
Psychologist
Primary
000984
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06072
WELLMARK BC BS
IA
Enumeration date
05/09/2006
Last updated
12/19/2007
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