Individual
GWEN HOHMAN-BULTJE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9400 WHEELERWOOD DR, CLEAR LAKE, IA 50428-9167
(641) 420-0891
(641) 423-2893
Mailing address
9400 WHEELERWOOD DR, CLEAR LAKE, IA 50428-9167
(641) 420-0891
(641) 423-2893
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00866
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0232330
—
IA
01
—
04822
WELLMARK
IA
Enumeration date
08/25/2006
Last updated
03/04/2019
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