| Emerald Bridges Family Therapy, Llc | |
|
2349 Jamestown Ave Suite 5 Independence IA 50644-9709 | |
| (563) 579-1181 | |
| (319) 332-1241 |
| Full Name | Emerald Bridges Family Therapy, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2349 Jamestown Ave, Independence, Iowa |
| Authorized Official Name and Position | Tara Nissen (MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 5635791181 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerald Bridges Family Therapy, Llc 914 Oregon St Waterloo IA 50702-2509 Ph: (563) 579-1181 | Emerald Bridges Family Therapy, Llc 2349 Jamestown Ave Suite 5 Independence IA 50644-9709 Ph: (563) 579-1181 |
| NPI Number | 1073966123 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073966123 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007613 (Iowa) | Primary |
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