Individual
SUSAN DAWN MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 HARMONY ST STE 302, COUNCIL BLUFFS, IA 51503-3106
(712) 328-2609
Mailing address
117 VALLEY ST, GLENWOOD, IA 51534-1024
(712) 527-1064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1314
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
20R002
IA
101YM0800X
Mental Health Counselor
099212
IA
101YM0800X
Mental Health Counselor
Primary
2243
NE
Other
Enumeration date
08/05/2016
Last updated
11/14/2023
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