| Waxwing Psychological Services, Pllc | |
|
700 16th St Ne Ste 206 Cedar Rapids IA 52402-4665 | |
| (319) 382-0751 | |
| Not Available |
| Full Name | Waxwing Psychological Services, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 700 16th St Ne Ste 206, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Anthony J. Mielke (OWNER, SUPERVISOR, THERAPIST) |
| Authorized Official Contact | 3193820751 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waxwing Psychological Services, Pllc 700 16th St Ne Ste 206 Cedar Rapids IA 52402-4665 Ph: (319) 382-0751 | Waxwing Psychological Services, Pllc 700 16th St Ne Ste 206 Cedar Rapids IA 52402-4665 Ph: (319) 382-0751 |
| NPI Number | 1063133189 |
|---|---|
| Provider Enumeration Date | 09/07/2022 |
| Last Update Date | 09/07/2022 |
| Certification Date | 09/07/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063133189 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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