Individual
REGINA MACRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
3600 30TH ST, BLDG 5 ROOM 105, DES MOINES, IA 50310-5753
(515) 699-5999
(515) 699-5772
Mailing address
3600 30TH ST, BLDG 5 ROOM 105, DES MOINES, IA 50310-5753
(515) 699-5999
(515) 699-5772
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00929
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0074583
—
IA
01
—
07458
WELLMARK/BLUE CROSS
IA
Enumeration date
06/29/2006
Last updated
08/23/2007
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