Individual
MRS. CARLA MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1441 W. CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 888-6275
Mailing address
1441 W. CENTRAL PARK AVE, DAVENPORT, IA 52804-1707
(563) 888-6275
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007906
IA
1041C0700X
Clinical Social Worker
14900125
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0581751
—
IL
01
—
149001125
BLUE CROSS ILLINOIS NUMBE
IL
05
—
1581751
—
IL
01
—
99085
BLUE CROSS IOWA NUMBER
IL
01
—
IL01A7
JOHN DEERE PROVIDER NUMBE
IL
01
—
P00122677
RR MEDICARE
IL
Enumeration date
08/26/2005
Last updated
09/04/2012
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