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Individual

MARY ANN M STRIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
201 RIDGE ST, SUITE # 105, COUNCIL BLUFFS, IA 51503-4643
(712) 396-7500
Mailing address
257 N 118TH ST, OMAHA, NE 68154-2216
(402) 333-5078

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
00157
IA
103TC0700X
Clinical Psychologist
Primary
00526
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00526
MEDICAL LICENSE
IA
05
0731968
IA
Enumeration date
06/12/2006
Last updated
07/08/2007
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