Organization
KATHERINE L. NYDAM OLIVIER, LISW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE L NYDAM OLIVIER LISW (PRESIDENT)
(319) 339-4757
Entity
Organization
Contact information
Practice address
757 W BENTON ST, IOWA CITY, IA 52246-5953
(319) 339-4757
Mailing address
757 W BENTON ST, IOWA CITY, IA 52246-5953
(319) 339-4757
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1041CO700X
—
IA
Enumeration date
11/22/2017
Last updated
11/22/2017
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